Thoracic Epidural Anaesthesia Was Not Able to Attenuate Stress-Induced Immunosuppression in Patients Undergoing Major Abdominal Surgery
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- Category: Vol. 81, June 2013
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Thoracic Epidural Anaesthesia Was Not Able to Attenuate Stress-Induced Immunosuppression in Patients Undergoing Major Abdominal Surgery,MOHAMED A. MAHMOUD and FATEN MAHMOUD
Abstract
Background: Blunting the perioperative stress response and preserving immune function are critical issues for patients undergoing major abdominal surgery.
Aim: The present study investigated whether perioperative thoracic epidural block affects postoperative immune response in patients undergoing major abdominal surgery.
Patients and Methods: Patients undergoing major abdom-inal surgery were randomly assigned to either general anes-thesia with continuous epidural infusion via epidural catheters that was continued for postoperative analgesia (group E, n=15) or intraoperative general anesthesia and postoperative IV morphine analgesia (group G, n=15). Plasma levels of C-reactive protein (CRP), leukocyte counts, and percentage of total lymphocytes were assessed before and after surgery and on postoperative days (PODs) 1 and 3.
Results: There were no significant differences in variables between groups. In both groups, Leukocyte counts were increased on POD1 (each group p<0.05) and POD3 (each group p<0.01). The proportion of lymphocytes decreased from the end of surgery to POD3 (each group p<0.01) and CRP were still increased on POD1 and POD3 (each change, each group p<0.01).
Conclusion: Tissue damage and inflammation apparently overcome the effects of thoracic epidural block on stress-induced immunosuppression in patients undergoing major abdominal surgery.