Abstract
We investigated whether perioperative extensive epidural block (C3-L) affects postoperative immune response in patients undergoing radical esophagectomy. Patients undergoing radical esophagectomy were randomly assigned to either general anesthesia with continuous epidural infusion via 2 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 stress hormones, cytokines, C-reactive protein (CRP), leukocyte counts, and distribution of lymphocyte subsets were assessed before and after surgery and on postoperative days (PODs) 1 and 3. In comparison with group E, significant increases in plasma epinephrine level at the end of surgery (P <0.05) and norepinephrine level at the end of surgery (P <0.01) and on POD1 (P <0.01) and POD3 (P <0.01) and significant decrease in cluster of differentiation (CD4/CD8 ratio) at the end of surgery (P <0.05) were observed in group G. However, there were no significant differences in other variables between groups. In both groups, plasma cortisol, adrenocorticotropic hormone, interleukin (IL)-1β, IL-6, IL-10, and CRP levels were increased after surgery (each group P <0.01) and IL-1β, IL-6, IL-10, and CRP were still increased on POD1 and POD3 (each change, each group P <0.01). 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). The proportion of B cells was increased on POD1 (each group P <0.01); that of natural killer cells was decreased at POD1 and POD3 (each group P <0.01). We conclude that tissue damage and inflammation apparently overcome the effects of extensive epidural block on stress response and immune function in radical esophagectomy.
| Original language | English |
|---|---|
| Pages (from-to) | 1521-1527 |
| Number of pages | 7 |
| Journal | Anesthesia and Analgesia |
| Volume | 101 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Nov 2005 |
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ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
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The effects of continuous epidural anesthesia and analgesia on stress response and immune function in patients undergoing radical esophagectomy. / Yokoyama, Masataka; Itano, Yoshitaro; Katayama, Hiroshi; Morimatsu, Hiroshi; Takeda, Yoshimasa; Takahashi, Toru; Nagano, Osamu; Morita, Kiyoshi.
In: Anesthesia and Analgesia, Vol. 101, No. 5, 11.2005, p. 1521-1527.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The effects of continuous epidural anesthesia and analgesia on stress response and immune function in patients undergoing radical esophagectomy
AU - Yokoyama, Masataka
AU - Itano, Yoshitaro
AU - Katayama, Hiroshi
AU - Morimatsu, Hiroshi
AU - Takeda, Yoshimasa
AU - Takahashi, Toru
AU - Nagano, Osamu
AU - Morita, Kiyoshi
PY - 2005/11
Y1 - 2005/11
N2 - We investigated whether perioperative extensive epidural block (C3-L) affects postoperative immune response in patients undergoing radical esophagectomy. Patients undergoing radical esophagectomy were randomly assigned to either general anesthesia with continuous epidural infusion via 2 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 stress hormones, cytokines, C-reactive protein (CRP), leukocyte counts, and distribution of lymphocyte subsets were assessed before and after surgery and on postoperative days (PODs) 1 and 3. In comparison with group E, significant increases in plasma epinephrine level at the end of surgery (P <0.05) and norepinephrine level at the end of surgery (P <0.01) and on POD1 (P <0.01) and POD3 (P <0.01) and significant decrease in cluster of differentiation (CD4/CD8 ratio) at the end of surgery (P <0.05) were observed in group G. However, there were no significant differences in other variables between groups. In both groups, plasma cortisol, adrenocorticotropic hormone, interleukin (IL)-1β, IL-6, IL-10, and CRP levels were increased after surgery (each group P <0.01) and IL-1β, IL-6, IL-10, and CRP were still increased on POD1 and POD3 (each change, each group P <0.01). 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). The proportion of B cells was increased on POD1 (each group P <0.01); that of natural killer cells was decreased at POD1 and POD3 (each group P <0.01). We conclude that tissue damage and inflammation apparently overcome the effects of extensive epidural block on stress response and immune function in radical esophagectomy.
AB - We investigated whether perioperative extensive epidural block (C3-L) affects postoperative immune response in patients undergoing radical esophagectomy. Patients undergoing radical esophagectomy were randomly assigned to either general anesthesia with continuous epidural infusion via 2 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 stress hormones, cytokines, C-reactive protein (CRP), leukocyte counts, and distribution of lymphocyte subsets were assessed before and after surgery and on postoperative days (PODs) 1 and 3. In comparison with group E, significant increases in plasma epinephrine level at the end of surgery (P <0.05) and norepinephrine level at the end of surgery (P <0.01) and on POD1 (P <0.01) and POD3 (P <0.01) and significant decrease in cluster of differentiation (CD4/CD8 ratio) at the end of surgery (P <0.05) were observed in group G. However, there were no significant differences in other variables between groups. In both groups, plasma cortisol, adrenocorticotropic hormone, interleukin (IL)-1β, IL-6, IL-10, and CRP levels were increased after surgery (each group P <0.01) and IL-1β, IL-6, IL-10, and CRP were still increased on POD1 and POD3 (each change, each group P <0.01). 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). The proportion of B cells was increased on POD1 (each group P <0.01); that of natural killer cells was decreased at POD1 and POD3 (each group P <0.01). We conclude that tissue damage and inflammation apparently overcome the effects of extensive epidural block on stress response and immune function in radical esophagectomy.
UR - http://www.scopus.com/inward/record.url?scp=27444434238&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=27444434238&partnerID=8YFLogxK
U2 - 10.1213/01.ANE.0000184287.15086.1E
DO - 10.1213/01.ANE.0000184287.15086.1E
M3 - Article
C2 - 16244024
AN - SCOPUS:27444434238
VL - 101
SP - 1521
EP - 1527
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
SN - 0003-2999
IS - 5
ER -