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Background: Cytokines are important mediators of immune response to surgery and pain. The aim of the study was to investigate the effect of remifentanil on serum levels of cytokines,tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), in patients undergoing laparoscopic hysterectomy. Methods: Twenty four patients scheduled for laparoscopic hysterectomy were randomly assigned to control or remifentanil group. Both groups received 1.5−2.5% end tidal concentration of sevoflurane and air in 50% oxygen. Remifentanil group received a bolus of remifentanil 1μg/kg over 1 min and an infusion of remifentanil at a rate of 0.1μg/kg/min. Control group received 10ml saline (placebo) and an infusion of saline at the same rate. Venous blood samples for measurement of serum cytokine concentrations were taken before anesthesia (T1), at 2 h after infusion (T2), and at the 1 hour after surgery (T3). Results: Serum TNF-α concentration did not differ significantly over time in both groups. Serum TNF-α concentration was higher in remifentanil group at T3 (9.76 ± 1.19 pg/ml vs. 8.53 ± 0.71pg/ml) than in control group (P < 0.05). In both groups, serum IL-6concentrations were significantly higher at T3, when compared to those at T1 and T2 (P < 0.05). Conclusions: Remifentanil did not attenuate early postoperative change of serum TNF-α and IL-6 concentrations in patients undergoing laparoscopic hysterectomy. Serum IL-6 level increased at postoperative 1 h, regardless of remifentanil use.