Journal of Clinical Anesthesia
Volume 21, Issue 6 , Pages 414-421 , September 2009

Lymphocyte apoptosis after major abdominal surgery is not influenced by anesthetic technique: a comparative study of general anesthesia versus combined general and epidural analgesia

Received 4 April 2007 ,Revised 26 October 2008 ,Accepted 30 October 2008.

References 

  1. Salo M. Effects of anaesthesia and surgery on the immune response. Acta Anaesthesiol Scand. 1992;36:201–220
  2. Oka M, Hirazawa K, Yamamoto K, et al. Induction of Fas-mediated apoptosis on circulating lymphocytes by surgical stress. Ann Surg. 1996;223:434–440
  3. Kobayashi E, Yamauchi H. Interleukin-6 and a delay of neutrophil apoptosis after major surgery. Arch Surg. 1997;132:209–210
  4. Delogu G, Moretti S, Antonucci A, et al. Apoptosis and surgical trauma: dysregulated expression of death and survival factors on peripheral lymphocytes. Arch Surg. 2000;135:1141–1147
  5. Yamada R, Tsuchida S, Hara Y, Tagawa M, Ogawa R. Apoptotic lymphocytes induced by surgical trauma in dogs. J Anesth. 2002;16:131–137
  6. Tonnesen E, Wahlgreen C. Influence of extradural and general anaesthesia on natural killer cell activity and lymphocyte subpopulations in patients undergoing hysterectomy. Br J Anaesth. 1988;60:500–507
  7. Moore CM, Desborough JP, Powell H, Burrin JM, Hall GM. Effects of extradural anaesthesia on interleukin-6 and acute phase response to surgery. Br J Anaesth. 1994;72:272–279
  8. Dzik WH. Apoptosis, TGF beta and transfusion-related immunosuppression: biologic versus clinical effects. Transfus Apher Sci. 2003;29:127–129
  9. Shigemitsu Y, Saito T, Kinoshita T, Kobayashi M. Influence of surgical stress on bactericidal activity of neutrophils and complications of infection in patients with esophageal cancer. J Surg Oncol. 1992;50:90–97
  10. Kerr JF, Wyllie AH, Currie AR. Apoptosis: a basic biological phenomenon with wide-ranging implications in tissue kinetics. Br J Cancer. 1972;26:239–257
  11. Sasajima K, Inokuchi K, Onda M, et al. Detection of T cell apoptosis after major operations. Eur J Surg. 1999;165:1020–1023
  12. Yokoyama M, Itano Y, Katayama H, et al. The effects of continuous epidural anesthesia and analgesia on stress response and immune function in patients undergoing radical esophagectomy. Anesth Analg. 2005;101:1521–1527
  13. Sugimoto M, Shimaoka M, Hosotsubo K, et al. Up-regulation of Fas ligand (FasL) mRNA expression in peripheral blood mononuclear cells (PBMC) after major surgery. Clin Exp Immunol. 1998;112:120–125
  14. Delogu G, Famularo G, Moretti S, et al. Interleukin-10 and apoptotic death of circulating lymphocytes in surgical/anesthesia trauma. J Trauma. 2001;51:92–97
  15. Blake DW. The general versus regional anaesthesia debate: time to re-examine the goals. Aust N Z J Surg. 1995;65:51–56
  16. Kim C, Sakamoto A. Differences in the leukocyte response to incision during upper abdominal surgery with epidural versus general anesthesia. J Nippon Med Sch. 2006;73:4–9
  17. Volk T, Schenk M, Voigt K, Tohtz S, Putzier M, Kox WJ. Postoperative epidural anesthesia preserves lymphocyte, but not monocyte, immune function after major spine surgery. Anesth Analg. 2004;98:1086–1092
  18. Rem J, Brandt MR, Kehlet H. Prevention of postoperative lymphopenia and granulocytosis by epidural analgesia. Lancet. 1980;1(8163):283–284
  19. Nieto MA, Lopez-Rivas A. Glucocorticoids activate a suicide program in mature T lymphocytes: protective action of interleukin-2. Ann NY Acad Sci. 1992;650:115–120
  20. Elenkov IJ, Wilder RL, Chrousos GP, Vizi ES. The sympathetic nerve: an integrative interface between two supersystems—the brain and the immune system. Pharmacol Rev. 2000;52:595–638
  21. Fong Y, Moldawer LL, Shires GT, Lowry SF. The biologic characteristics of cytokine and their implication in surgical injury. Surg Gynecol Obstet. 1990;170:363–378
  22. Kehlet H. Manipulation of the metabolic response in clinical practice. World J Surg. 2000;24:690–695
  23. Brodner G, Van Aken H, Hertle L, et al. Multimodal perioperative management–combining thoracic epidural analgesia, forced mobilization, and oral nutrition–reduces hormonal and metabolic stress and improves convalescence after major urologic surgery. Anesth Analg. 2001;92:1594–1600
  24. Beilin B, Shavit Y, Trabekin E, et al. The effects of postoperative pain management on immune response to surgery. Anesth Analg. 2003;97:822–827
  25. Mellon RD, Bayer BM. Evidence for central opioid receptors in the immunomodulatory effects of morphine: review of potential mechanism(s) of action. J Neuroimmunol. 1998;83:19–28
  26. Page GG, Blakely WP, Ben-Eliyahu S. Evidence that postoperative pain is a mediator of the tumor-promoting effects of surgery in rats. Pain. 2001;90:191–199
  27. Brand JM, Frohn C, Luhm J, Kirchner H, Schmucker P. Early alterations in the number of circulating lymphocyte subpopulations and enhanced proinflammatory immune response during opioid-based general anesthesia. Shock. 2003;20:213–217
  28. Liu SS, Allen HW, Olsson GL. Patient-controlled epidural analgesia with bupivacaine and fentanyl on hospital wards: prospective experience with 1,030 surgical patients. Anesthesiology. 1998;88:688–695

PII: S0952-8180(09)00211-6

doi: 10.1016/j.jclinane.2008.10.015

Journal of Clinical Anesthesia
Volume 21, Issue 6 , Pages 414-421 , September 2009