Immunological Modifications Induced from Products Used during the Perioperative Period

Abstract

Anesthetics and other products used during the perioperative period may influence immune function not only merely by reducing the HPA-axis stress response but also by directly modulating innate and adaptive immune responses. Most of the literature on the immune effects of anesthetics has been derived from in vitro or animal studies, due to the number of confounding variables in “real life” surgical settings. These immunosuppressive effects might not normally have clinical consequences for an immune-competent patient, but may act as important modifiers in postoperative morbidity and mortality. Furthermore, some inhibitory effects on neutrophil functions may provide a therapeutically beneficial effect under specific surgical clinical conditions, such as ischemia-reperfusion injury.

Effects of Different Anesthetic Methods on Cellular Immune and Neuroendocrine Functions in Patients With Hepatocellular Carcinoma Before and After Surgery

“…Changes in inflammatory cytokines (IL-6, IL-10 and IFN-c) at different time points in the two groups (IL-6: interleukin-6; IL-10: interleukin-10; IFN-c: interferon-c; T0: before surgery; T1: 0 hr after surgery; T2: 12 hr after surgery; T3: 24 hr after surgery; T4: 72 hr after surgery); (a) changes in IL-6 levels at different time points in the two groups; (b) changes in IL-10 levels at different time points in the two groups; (c) changes in IFN-c levels at different time points in the two groups; *: compared with before surgery, P < 0.05; # , compared with the same time point in the combined intravenous and inhalation anesthesia group, P < 0.05). the treatment of HCC may exert different effects in terms of the hormone and enzyme levels in patients, these hormones and enzymes play an important role in the differences in systemic stress responses that are controlled by inflammatory cytokines (33,34). Inflammatory cytokines can regulate a variety of physiologic functions within an organism, and they may exert some effects on reactions to stress, including trauma, pain and infection (35).…”

“…Surgery is the first‐line treatment for liver cancer, and the different anesthetic methods that are used in the treatment of HCC may exert different effects in terms of the hormone and enzyme levels in patients, these hormones and enzymes play an important role in the differences in systemic stress responses that are controlled by inflammatory cytokines . Inflammatory cytokines can regulate a variety of physiologic functions within an organism, and they may exert some effects on reactions to stress, including trauma, pain and infection .…”

Open versus laparoscopic liver resection for colorectal liver metastases (the Oslo-CoMet study): study protocol for a randomized controlled trial

“…The optimal management of pain following major abdominal surgery is subject to on-going debate. Epidural analgesia after open abdominal surgery has been shown to reduce pain [ 30 ], postoperative ileus [ 31 ] and inflammatory response [ 32 , 33 ], but it also carries rare but severe complications such as post-dural puncture headache and paralysis of lower extremities. A recent systematic review concludes that large-scale prospective randomized trials are required to find the optimal management of postoperative pain after open liver resection [ 34 ].…”

Association Between Preoperative 25-Hydroxyvitamin D Level and Hospital-Acquired Infections Following Roux-en-Y Gastric Bypass Surgery

“…In essence, robust postoperative immune function is associated with a lower likelihood of HAIs. 18–20 However, it is important to note that aside from the use of neuraxial anesthesia, all existing strategies to minimize HAIs look to modify factors external to the host. Moreover, to our knowledge, few studies have looked at methods of optimizing natural host responses to infection in the perioperative setting.…”

“…Moreover, to our knowledge, few studies have looked at methods of optimizing natural host responses to infection in the perioperative setting. 18–20 …”