Intraoperative thoracic epidural anaesthesia attenuates stress-induced immunosuppression in patients undergoing major abdominal surgery

Abstract

Intraoperative use of thoracic epidural catheter reduced stress response and prevented stress-induced perioperative impairment of proinflammatory lymphocyte function.

Early Effect of Tidal Volume on Lung Injury Biomarkers in Surgical Patients With Healthy Lungs

“…Our low detection rate is similar to findings in other studies in healthy patients ventilated during surgery 2 and reinforces the normal pulmonary status of our study patients. Plasma cytokine concentrations did not significantly change in relation to surgical trauma or greater V T. Possible contributing factors to this finding were the short study duration, lack of lung injury, or preoperative regional anesthesia 67,68 . However, the inhibitory effect of regional anesthesia on systemic inflammatory response after orthopedic surgery is still unproven 69,70 .…”

Effects of flurbiprofen axetil on postoperative serum IL-2 and IL-6 levels in patients with colorectal cancer

“…Immune suppression accelerates residual tumor cell growth and metastasis. Typically, immune dysfunction causes infection and septicemia in postoperative patients or patients in the intensive care unit and can lead to infectious shock, multiple organ failure, or even death (Ahlers et al, 2008). Our results indicate that morphine, tramadol, and flurbiprofen axetil all effectively attenuated postoperative pain and decreased the incidence of complications, but opioids may aggravate immune suppression and cause poor prognosis for patients.…”

Abdominal Surgery: Advances in the Use of Ultrasound-Guided Truncal Blocks for Perioperative Pain Management

“…Lymphocyte numbers and T-helper cells are significantly higher in the epidural group on day one, whereas no significant differences may be detected among IL-2, HLA-DR, or the postoperative clinical course. Intraoperative use of a thoracic epidural catheter may therefore reduce stress response and prevent stress-induced perioperative impairment of pro-inflammatory lymphocyte function (Ahlers 2008). However, other studies find that epidural analgesia cannot suppress postoperative lymphocyte apoptosis, increases in cortisol, CRP or ESR compared with general anaesthesia, so the evidence is equivocal (Papadima 2009).…”