Background: Open cholecystectomy is an operation which is often carried out with the aim of removing the gallbladder. In this operation an incision was performed along a 10-15 cm line in the right subcostal or midline area under the epigastric area. Here postoperative pain is a common problem that must be taken into consideration. PGE2 and IL-6 are the predominant cytokines that are released after trauma from surgery and associated with inflammation of pain. Methylprednisolone is a glucocorticoid that has been reported to reduce postoperative pain in addition to inhibiting hyperalgesia of inflammatory mediator IL-6 and PGE2.
Material and methods: The level of pain was assessed during the 1st hour of surgery, the 2nd, 4th, 8th, 12th and 24th hour consecutively. 125 mg of methylprednisolone was injected intravenously 60 minutes before the operation and 30 minutes before completing the skin sutures. For Group I: methylprednisolone was given postoperatively; Group II: methylprednisolone was given before surgery; and for Group III, the Control Group. Each Group number included a sample of 10 patients with the following inclusion criteria: ASA clinical classification I-II, age 20-60 years.
Results: The study showed that the treatment reduced postoperative IL-6 levels significantly (p=0.0000), except in the 24th hour (p=0.4999). The postoperative PGE2 was not significantly changed (p>0.05).
Conclusion: The levels of IL-6 in open cholecystectomy that were given methylprednisolone intravenously preoperatively were lower than given postoperatively, but were not reduced for the PGE2 level. Methylprednisolone administered intravenously before open cholecystectomy is able to decrease postoperative pain.
Keywords: Methylprednisolone, open cholecystectomy, IL-6, PGE2