Intraoperative dynamics of interleukin-6 levels during planned coronary stenting with different approaches to analgesic sedation

Abstract

The aim – to study the dynamics of the level of interleukin-6 (IL-6) under various drugs for analgesic sedation in the perioperative period of planned coronary stenting. Materials and methods. This study was conducted from September 2018 to March 2020 in 90 patients with coronary heart disease. Patients were evenly divided into three study groups, depending on the drugs that were used for intraoperative analgosedation. Group 1 – slow intravenous administration of 10 mg of diazepam solution and 100 μg of fentanyl solution for induction and repeated administration of these drugs in the same dose to maintain anesthesia during surgery; group 2 – slow intravenous administration of the solution of fentanyl 1.5 mg/kg per induction and 1.5 mg/kg for 1 h to maintain analgesia, propofol solution was used to maintain a certain level of sedation; group 3 – slow intravenous administration of 1 mg/kg of lidocaine solution for induction, for sedation – propofol solution as well. All patients underwent recanalization as planned. In our study, the main study parameter was the level of IL-6 at the beginning of surgery and 10 minutes after stent implantation. Results. When comparing operational indicators with the results that were obtained after stenting, in all groups, IL-6 indicators were lower than preoperative ones. The statistically significant difference between the studied index before surgery and 10 min after stent implantation was in the groups 2 and 3, in contrast to that in patients of the group 1: the level of IL-6 decreased to 30 % in group 2 (p = 0.005) and in group 3 (p = 0.001). Conclusions. The level of pro-inflammatory IL-6 in routine coronary artery stenting tends to decrease after stent placement, with lower rates under propofol solution usage as an anesthetic. At the same time, in group 3 (where nonopioid analgesia was used) the level of interleukin-6 at point 10 min after stent implantation was significantly lower than in first group. This fact might be explained by usage of lidocaine solution in patients of the third group. Key words: interleukin-6, planned coronary stenting, analgosedation, coronary heart disease.