• Markus Klimek, Jaap W Hol, Stephan Wens, Claudia Heijmans-Antonissen, Sjoerd Niehof, Arnaud J Vincent, Jan Klein, and Freek J Zijlstra.
• Department of Anesthesiology, Erasmus MC, P. O. Box 2040, 3000 CA Rotterdam, The Netherlands. m.klimek@erasmusmc.nl
• Mediators Inflamm. 2009 Jan 1; 2009: 670480.

BackgroundSurgical stress triggers an inflammatory response and releases mediators into human plasma such as interleukins (ILs). Awake craniotomy and craniotomy performed under general anesthesia may be associated with different levels of stress. Our aim was to investigate whether those procedures cause different inflammatory responses.MethodsTwenty patients undergoing craniotomy under general anesthesia and 20 patients undergoing awake function-controlled craniotomy were included in this prospective, observational, two-armed study. Circulating levels of IL-6, IL-8, and IL-10 were determined pre-, peri-, and postoperatively in both patient groups. VAS scores for pain, anxiety, and stress were taken at four moments pre- and postoperatively to evaluate physical pain and mental duress.ResultsPlasma IL-6 level significantly increased with time similarly in both groups. No significant plasma IL-8 and IL-10 change was observed in both experimental groups. The VAS pain score was significantly lower in the awake group compared to the anesthesia group at 12 hours postoperative. Postoperative anxiety and stress declined similarly in both groups.ConclusionThis study suggests that awake function-controlled craniotomy does not cause a significantly different inflammatory response than craniotomy performed under general anesthesia. It is also likely that function-controlled craniotomy does not cause a greater emotional challenge than tumor resection under general anesthesia.

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