Journal of Clinical Anesthesia
Volume 24, Issue 1 , Pages 3-7, February 2012

Meta-analysis of the effect of central neuraxial regional anesthesia compared with general anesthesia on postoperative natural killer T lymphocyte function☆

  • Ian Conrick-Martin, FCAI, MRCPI, DIBICM (Specialist Registrar in Anaesthesia)

      Affiliations

    • Department of Anaesthesia, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland
    • Corresponding Author InformationCorrespondence: Ian Conrick-Martin, FCAI, MRCPI, DIBICM, Department of Anaesthesia, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland. Tel.: +353 1 803-2281; fax: +353 1 830-9563.
    • ,
  • Malcolm R. Kell, MD, FRCSI, FRCS(Glasg) (Consultant Surgeon)

      Affiliations

    • Department of Surgery, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland
    • ,
  • Donal J. Buggy, MD, MSc, FRCPI, FCAI, FRCA (Professor of Anaesthesia; Consultant in Anaesthesia)

      Affiliations

    • Department of Anaesthesia, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland
    • Outcomes Research Consortium, Cleveland Clinic, OH, USA

Received 4 September 2010; received in revised form 3 August 2011; accepted 6 September 2011.

Abstract 

Study Objective

To compare the effect of central neuraxial (spinal or epidural) anesthesia with general anesthesia on postoperative natural killer (NK) T lymphocyte function.

Design

Meta-analysis.

Setting

University-affiliated hospital.

Measurements

A systematic search of the medical literature from 1966 to 2009 yielded 5 eligible studies with a total of 184 patients who received neuraxial blockade. Natural killer T lymphocyte function was studied.

Main Results

There was significant heterogeneity between the studies [I2 = 94.4% (95% CI= 90.3-96.2%)]. Overall fixed-effect odds ratio was 0.86 (0.66-1.14, P = 0.25). The random-effect odds ratio was 1.13 (0.26-4.92, P = 0.79).

Conclusion

Anesthetic technique does not appear to significantly affect postoperative NK T lymphocyte function. Given the heterogeneity observed, further clinical studies in cancer patients of the effect of anesthetic technique on immune function in general, and NK T lymphocyte function in particular, are needed.

Keywords: Anesthesia: general, regional neuraxial, Cancer patients, Natural killer T lymphocyte, Surgical stress response

 

☆ Supported by the Sisk Foundation, Dublin, and the Eccles Breast Cancer Research Fund, Dublin, Ireland.

PII: S0952-8180(11)00326-6

doi:10.1016/j.jclinane.2011.09.001

Journal of Clinical Anesthesia
Volume 24, Issue 1 , Pages 3-7, February 2012

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