Effect of epidural and intravenous clonidine on the neuro-endocrine and immune stress response in patients undergoing lung surgery

Abstract

increased in all groups at the end of surgery, but the increase was least in the epidural clonidine group. The effects of intravenous and epidural clonidine, The number of lymphocytes was reduced at the end 4 g kg −1 , combined with epidural morphine, of surgery in the epidural and intravenous group, 40 g kg −1 , on the neuro-endocrine and immune stress compared with the control group in which the number responses to thoracic surgery are reported. A control of lymphocytes did not change. The effects are more group received only epidural morphine. Anaesthesia pronounced with epidural than with intravenous adwas induced and maintained with propofol. Caministration. We conclude that clonidine can modulate techolamines, vasopressin, cortisol, -endorphin conthe immune stress response to thoracic surgery. centrations and leucocyte counts were measured before drug administration, immediately after in-Keywords: thoracic surgery, stress responses, tubation of the trachea, after thoracotomy and at the catecholamines, vasopressin, cortisol -endorphin, end of surgery. Catecholamines did not change in any leucocytes; alpha 2 -adrenoceptor agonist, clonidine; of the groups. The other stress hormones increased epidural anaesthesia, clonidine, morphine; clonidine, during surgery, the pattern being similar in the three groups. Total leucocyte and neutrophil counts were epidural, intravenous. Accepted August 1999 idine, combined with epidural morphine, on the neuro-

The influence of anaesthesia on cancer growth

“… 21 , 22 In addition to the choice of anaesthetic, different regional techniques (epidural, paravertebral anaesthesia) also influence perioperative inflammation depending on the anaesthetics used. 23 , 24 …”

“…21,22 In addition to the choice of anaesthetic, different regional techniques (epidural, paravertebral anaesthesia) also influence perioperative inflammation depending on the anaesthetics used. 23,24 Transfusion of blood derivatives reduces the number of T-cytotoxic leukocytes, TNF production and macrophage chemotaxis. 25 Finally, the central nervous system also has an effect on perioperative stress and the immune response, which is the subject of psychoneuroimmunology.…”

Regional Anaesthesia in Thoracic and Abdominal surgery

“…On the other hand, prolonged or intense stimulation of these systems can be the cause of chronic or neuropathic pain ( 1 ). Immune response was reduced (decreased number of leucocytes, segmental neutrophils and lymphocytes) when clonidine was used as additive to epidural mixture lung surgery ( 8 ).…”