Effects of propofol and ketamine as induction anesthetics on serum TNF-α levels in patients diagnosed withcervical carcinoma
Medical Review (Med. pregled), 2025, 61(6), 39-48.
M. Georgiev1, K. Tsvetanova1, Ts. Vitkova2
1 Department of Anesthesiology and Intensive Care, Medical University – Pleven
2 Department of Hygiene, Medical Ecology, Occupational Diseases and Emergency Medicine, Medical University – Pleven
Abstract. The drugs used during anesthesia have a proven effect on various components of immunity. In relation to the expression of TNF-α, some of them have a suppressive effect, and others have an enhancing effect. Objective: To monitor the dynamic changes in serum TNF-α levels in three consecutive stages – preoperatively, imme- diately after the end of anesthesia and on the first postoperative day in patients with cervical cancer operated on with the Da Vinci robot-assisted system, who received different anesthetics for induction of general anesthesia (propofol and ketamine). Materials and Methods: 61 patients with a diagnosis of cervical cancer, operated on with the Da Vinci robotic system at the University Hospital “Sv. Marina” – Pleven, in the period 2022-2023, were studied. Serum TNF-α levels were measured by the ELISA method using serum from venous blood taken three times – before surgery, immediately after
the end of surgery and on the first postoperative day. Results: Based on the present study, we found that serum TNF-α levels had almost no dynamics in the preoperative and postoperative levels in the patient group, in which propofol was used, but in the group, in which ketamine was used, a statistically significant increase in serum levels was demonstrated on the first postoperative day compared to preoperative levels. Conclusion: In the present study, we demonstrated that the two introductory anesthetics (propofol and ketamine) have different effects on the serum TNF-α levels – ketamine increases serum levels of the marker immediately after surgery and even more significantly on the first postoperative day compared topreoperative levels, and propofol practically has no effect on the measured serum levels in the three stages of the study.
Key words: TNF-α, general anesthesia, anesthetics, cervical cancer, robot-assisted surgery
Address for correspondence: Mihail Georgiev, MD, e-mail: m.georgiev93@abv.bg