Factors associated with postoperative systemic inflammation in patients after major abdominal surgery

ABSTRACT Context: Inflammation in the perioperative period has been increasingly investigated along with its association with the surgical outcomes. Aims: The aim of this analysis was to examine the association of perioperatively administered lidocaine, amino acids, and magnesium on the CRP levels as an inflammation marker 3 days postoperatively. Settings and Design: This was the secondary analysis of the data from the prospective, double-blind randomized study. Materials and Methods: The study was conducted between 2011 and 2022 in the Clinical Centre of Montenegro and included total of 100 patients, randomized in two groups experimental and control. Statistical Analysis Used: Linear regression was used to examine the factors associated with the CRP level at 3 days postoperatively. All variables found to be significant in the univariate analyses were included in the multiple linear regression model, with CRP level 3 days after surgery as the outcome variable. Results: Mean CRP max was 173.97 mg/l. Multiple linear regression with CRP level at 3 days postoperatively as an outcome variable showed the association of CRP level at 3 days postoperatively with group in the study (experimental vs. control) and with the preoperative CRP levels. Conclusion: These results are in line with the notion of pharmacological and nutritional interventions aiming at the reduction of postoperative inflammation. Further studies are necessary to confirm these findings but also to shed the light on the underlying mechanisms, define the optimal dosing and timing of these interventions all aiming the maximum patient benefit.