Objective An acute severe stress response associated with major surgery can adversely affect the inflammatory and hormonal responses.We hypothesised that total intravenous anaesthesia (TIVA) combined with thoracic epidural anaesthesia and analgesia (TEA) attenuates the stress response and postoperative pain in patients undergoing radical oesophagectomy.Methods Forty patients scheduled for elective radical oesophagectomy were randomly assigned to one of two groups: Inclusive Fitness Affects Both Prosocial and Antisocial Behavior: Target Gender and Insult Domain Moderate the Link between Genetic Relatedness and Aggression TIVA or TIVA+TEA.The plasma levels of stress hormones and cytokines, consumption of fentanyl, postoperative visual analogue scale (VAS) scores within 48 hours, and extubation time were assessed.Results The plasma levels of interleukin-6, norepinephrine, cortisol, and adrenocorticotropic hormone Bacterial assessment of food handlers in Sari City, Mazandaran Province, north of Iran at 3 hours after the beginning of surgery were significantly higher in the TIVA group than TIVA+TEA group.
The plasma level of interleukin-10 at 3 hours after the beginning of surgery was significantly lower in the TIVA group than TIVA+TEA group.The consumption of fentanyl was significantly greater, VAS scores were significantly higher, and extubation time was significantly longer in the TIVA group than TIVA+TEA group.Conclusions The findings suggest that combination of TIVA and TEA may attenuate the intraoperative stress response and postoperative pain in patients undergoing radical oesophagectomy.