COMPARAÇÃO DA PCR E IL-6 COMO MARCADORES INFLAMATÓRIOS PÓS AMIGDALECTOMIA IMEDIATA

Abstract

Introduction: palatal tonsillectomy is the surgical removal of the tonsils, an extremely common procedure. As with any surgery, trauma induces an immune, endocrine and metabolic response, with the release of several cytokines, such as IL-6 and CRP, reflecting the size of the trauma and other factors. Serum levels of IL-6 and CRP may be useful in evaluating operative techniques and therapeutic strategies. Objectives: to evaluate the laboratory variation of IL-6 and CRP between preoperative and immediate postoperative periods of palatine tonsillectomies, with or without adenoidectomy. There is a secondary objective of comparison between separate groups according to surgical indication. Methods: 20 patients undergoing palatal tonsillectomies, with or without adenoidectomy, had serum samples taken to measure IL-6 and CRP at anesthetic induction and just before discharge. Group I, with inflammatory indications, had 15 patients, while group II, with obstructive indications, had 5. Pre- and postoperative dosages were compared, as well as levels and variations between groups. Results: CRP levels did not change due to surgery, while IL-6 levels increased considerably (p<0.001). The surgical indication of an inflammatory nature seems to have a significant impact on the patients' preoperative CRP levels, which were higher compared to the levels of patients without an inflammatory indication. On the other hand, the type of surgical procedure seemed to influence the variation in IL-6 levels (p=0.03). Conclusion: IL-6 is more sensitive than CRP to evaluate the post-surgical inflammatory process of palatal tonsillectomies, with or without adenoidectomy, in the first 6 post-surgical hours. It was hypothesized that patients with inflammatory surgical indications had higher baseline levels of CRP and IL-6, but further studies are needed to confirm this. IL-6 also appeared to increase more in patients undergoing palatal tonsillectomies with adenoidectomy.