Effects of spinal versus general anesthesia on serum oxidative stress markers and cytokine release after abdominal hysterectomy: a non-randomized trial

Anesthetic techniques can significantly influence postoperative outcomes by modulating inflammatory cytokine release and oxidative stress (OS). This study aimed to compare serum levels of OS biomarkers and inflammatory cytokines in patients undergoing abdominal hysterectomy under spinal anesthesia (SA) or general anesthesia (GA). A single-blinded, non-randomized controlled trial was conducted on forty-two patients (American Society of Anesthesiologists (ASA) class I and II) undergoing abdominal hysterectomy. Two groups of patients were assigned: SA and GA. To measure the levels of inflammatory cytokines (tumor necrosis factor-alpha [TNF-α], interleukin-1 beta [IL-1β], and interleukin-6 [IL-6]), as well as anti-inflammatory cytokine (interleukin-10 [IL-10]) and oxidative stress (OS) biomarkers (superoxide dismutase [SOD], catalase [CAT], and malondialdehyde [MDA]), blood samples were collected both before anesthesia and 48 h after surgery. Postoperatively, the serum levels of MDA significantly increased, while enzyme activity of CAT decreased in the GA group compared to pre-anesthesia levels. The MDA concentration was significantly higher in the GA group compared to the SA group. Besides, the SOD activity was significantly lower in the GA group than in the SA group. TNF-α and IL-6 serum levels were raised in the GA group postoperatively compared to pre-anesthesia levels. Furthermore, the concentration of TNF-α and IL-6 was significantly higher in the GA group than in the SA group. There was a notable difference in the ratio of IL-6/IL-10 between the two groups. GA significantly increased inflammatory factor levels and decreased serum antioxidants after abdominal hysterectomy compared to SA. These results indicate a lower inflammatory response to SA than GA.