Effects of epidural anaesthesia on surgical stress-induced immunosuppression during upper abdominal surgery

Abstract

This study showed that the innate immune system is suppressed from the early period of upper abdominal surgery. Subgroup analysis suggested that epidural anaesthesia to T4 dermatome as well as general anaesthesia may not protect patients from this immunosuppression. These results in part explain the impairment of host-defense mechanisms seen in the perioperative period.

The Effect of General Anesthesia and Thoracic Epidural Analgesia on Stress Response and Homocysteine Levels in Major Upper Abdominal Surgery: A Prospective Randomised Study

“…They reported significant leukocytosis and lymphopenia during surgery, but detected no significant differences between the groups. 19 In our study, there was a significant increase in neutrophil numbers in both groups compared to basal values. Neutrophil numbers continued to rise at postoperative hours 8 and 24 compared to the values at the end of surgery.…”

The Stress Response and Its Functional Implications in the Immune Response After Surgery in Patients with Chronic Inflammation Undergoing Arthroplasty

“…Regional anaesthesia decreases the neuroendocrine response but does not influence on the inflammatory response (Moor et al, 1994;Naito et al, 1992;Høgevold et al, 2000). Both, the regional and general anaesthesia does not significantly influence on the postoperative immunosuppression decrease [Kawasaki et al, 2007). As the matter of fact, the postoperative changes demonstrated in this study may reflect the modulation of immune response to stress surgery due to the chronic inflammatory response.…”

Perbandingan Pulihnya Syok pada Sindrom Syok Dengue Memakai Ringer Laktat Alice</given_name> <surname>Yuniati</surname> </person_name> <person_name sequence='additional' contributor_role='author'> <given_name>Agus </given_name> <surname>Purwanto</surname> </person_name> </contributors> <publication_date media_type='print'> <month>09</month> <year>2013</year> </publication_date> <publication_date media_t

“…Hal ini memperlihatkan input neural yang berasal dari luka operasi penting di dalam mekanisme aktivasi aksis hypophisispituary-adrenal (HPA) di tingkat otak, hipofisis, dan kelenjar adrenal. 4 Cedera pembedahan yang menginduksi jalur nosiseptif yang mengarah pada aktivasi respons stres neuroendokrin akan berperan pada efek samping luaran perioperatif. Terdapat dua bentuk input dari jaringan inflamasi ke SSP.…”