Influence of Anaesthetic Techniques on Inflammatory Response and Stress Biomarkers in Patients Undergoing Gynaecologic Oncology Surgeries.

Background: Gynecologic oncology surgeries are often extensive and associated with significant physiological stress and inflammation. Anesthetic technique may modulate perioperative immune and stress responses, potentially influencing postoperative outcomes. Methods: A prospective, randomized clinical study was conducted on 80 patients (aged 35-65 years) undergoing gynecologic oncology surgeries. Patients were randomly assigned to two groups: Group T (TIVA with propofol and remifentanil) and Group I (IA with sevoflurane and fentanyl). Blood samples were collected preoperatively (T0), immediately after surgery (T1), and 24 hours postoperatively (T2) to measure interleukin-6 (IL-6), C-reactive protein (CRP), cortisol, and epinephrine levels. Hemodynamic stability and postoperative complications were also evaluated. Results: IL-6 and CRP levels were significantly lower in Group T at T1 and T2 (IL-6 at T2: 65.3 ± 12.4 pg/mL vs. 94.1 ± 14.8 pg/mL, P < 0.001; CRP at T2: 3.9 ± 0.7 mg/dL vs. 5.6 ± 1.1 mg/dL, P < 0.001). Cortisol and epinephrine levels were also significantly reduced in Group T at T1 (cortisol: 422.6 ± 60.3 nmol/L vs. 569.7 ± 82.1 nmol/L, P < 0.01). Group T demonstrated better hemodynamic control and fewer postoperative nausea and vomiting episodes. Conclusion: TIVA attenuated the inflammatory and stress biomarker response more effectively than inhalational anesthesia in patients undergoing gynecologic oncology surgeries. TIVA may offer potential benefits in perioperative immune modulation and recovery in this patient population.