Comparison of Serum Interleukin 6, Leptin, and Adiponectin Levels after Cesarean Section Under General Versus Spinal Anesthesia

Abstract

Background: Inflammatory cytokines negatively impact postoperative reactions and outcomes in abdominal surgeries. Objectives: This study investigates the effect of general and spinal anesthesia (SA) on the serum levels of leptin, adiponectin, and interleukin-6 (IL-6) 24 hours after cesarean sections (CS) conducted with spinal or general anesthesia (GA). Methods: This cross-sectional study was conducted at Sayad Shirazi Hospital in Gorgan, IR. Iran, in 2024. Eighty pregnant women who were scheduled for CS were enrolled in the study. All participants satisfied the criteria for both general and SA, and the method of anesthesia was randomly assigned to each participant. Exclusion criteria included autoimmune diseases, preeclampsia, hypertension, gestational diabetes, a gestational age < 37 weeks, those who received blood transfusions and/or intubation. Participants were divided into two groups based on the anesthesia method after the CS: GA and SA. General anesthesia was administered using propofol and sodium thiopentone combined with atracurium and cis-atracurium. Bupivacaine and ropivacaine were used for SA. Peripheral blood samples were collected 24 hours post-operation to measure IL-6, leptin, and adiponectin levels. Results: A comparison of serum cytokine levels revealed that 24 hours after CS, IL-6, adiponectin, and leptin were significantly higher in the GA than in the SA group (P < 0.001 for all). In the SA group, there were positive and significant correlations among the following variables: IL-6 and leptin (r = 0.641, P < 0.001), IL-6 and adiponectin (r = 0.617, P < 0.001), as well as between leptin and adiponectin (r = 0.742, P < 0.001). In the GA group, a positive and significant correlation was found between the pro-inflammatory cytokines leptin and IL-6 (r = 0.316, P = 0.047). Conclusions: The present research found elevated leptin, IL-6, and adiponectin levels in CS cases that underwent GA.