Comparison of IL-6 and TNF-α Level Measurements in Patients Given Intravenous Ketorolac and Lidocaine in Postoperative Digestive Surgery Patients

Abstract

Background: Digestive surgery triggers a systemic inflammatory response mediated by pro-inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). This response can lead to postoperative complications such as ileus and delayed healing. Inflammation management involves medications such as lidocaine, which has anti-inflammatory effects, and ketorolac, which is effective in reducing opioid requirements. However, no studies have compared the effectiveness of the two. Objective: Comparing IL-6 and TNF-α levels in post-digestive surgery patients between the lidocaine and ketorolac groups. Research Method: This study was a randomized clinical trial at Dr. Soetomo General Hospital, involving 28 patients. Data were analyzed using SPSS and the Friedman test. Results: IL-6 levels 0 hours postoperatively in the ketorolac group were 8.38 pg/mL and increased to 9.91 pg/mL at 2 hours postoperatively, while in the lidocaine group, IL-6 levels 0 hours postoperatively were 5.40 pg/mL and decreased to 4.59 pg/mL. However, no significant differences were discovered among the two groups at any time point (p=0.587; p=0.215; p=0.098). For TNF-α levels, the ketorolac group showed an increase from 10.60 pg/mL to 12.78 pg/mL, while the lidocaine group increased from 14.57 pg/mL to 16.00 pg/mL. The Mann-Whitney test results also uncovered no significant within between the two groups (p=0.135–0.854). Conclusion: Neither ketorolac nor lidocaine produced significant differences in postoperative IL-6 and TNF-α levels.