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 ,Revised 3 August 2011 ,Accepted 6 September 2011.

References 

  1. Ó Riain SC, Buggy DJ, Kerin MJ, Watson RW, Moriarty DC. Inhibition of the stress response to breast cancer surgery by regional anesthesia and analgesia does not affect vascular endothelial growth factor and prostaglandin E2. Anesth Analg. 2005;100:244–249
  2. Exadaktylos AK, Buggy DJ, Moriarty DC, Mascha E, Sessler DI. Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis?. Anesthesiology. 2006;105:660–664
  3. Biki B, Mascha E, Moriarty DC, Fitzpatrick JM, Sessler DI, Buggy DJ. Anesthetic technique for radical prostatectomy surgery affects cancer recurrence: a retrospective analysis. Anesthesiology. 2008;109:180–187
  4. Sessler DI, Ben-Eliyahu S, Mascha EJ, Parat MO, Buggy DJ. Can regional analgesia reduce the risk of recurrence after breast cancer? Methodology of a multicenter randomized trial. Contemp Clin Trials. 2008;29:517–526
  5. Galley HF, Dubbels AM, Webster NR. The effect of midazolam and propofol on interleukin-8 from human polymorphonuclear leukocytes. Anesth Analg. 1998;86:1289–1293
  6. Buggy DJ, Smith G. Epidural anaesthesia and analgesia: better outcome after major surgery? Growing evidence suggests so. BMJ. 1999;319(7209):530–531
  7. Trinchieri G. Biology of natural killer cells. Adv Immunol. 1989;47:187–375
  8. Ben-Eliyahu S, Page GG, Yirmiya R, Shakhar G. Evidence that stress and surgical interventions promote tumor development by suppressing natural killer cell activity. Int J Cancer. 1999;80:880–888
  9. Bar-Yosef S, Melamed R, Page GG, Shakhar G, Shakhar K, Ben-Eliyahu S. Attenuation of the tumor-promoting effect of surgery by spinal blockade in rats. Anesthesiology. 2001;94:1066–1073
  10. Melamed R, Bar-Yosef S, Shakhar G, Shakhar K, Ben-Eliyahu S. Suppression of natural killer cell activity and promotion of tumor metastasis by ketamine, thiopental, and halothane, but not by propofol: mediating mechanisms and prophylactic measures. Anesth Analg. 2003;97:1331–1339
  11. Shavit Y, Ben-Eliyahu S, Zeidel A, Beilin B. Effects of fentanyl on natural killer cell activity and on resistance to tumour metastasis in rats. Dose and timing study. Neuroimmunomodulation. 2004;11:255–260
  12. Koltun WA, Bloomer MM, Tilberg AF, et al. Awake epidural anesthesia is associated with improved natural killer cell cytotoxicity and a reduced stress response. Am J Surg. 1996;171:68–72
  13. Lau J, Ioannidis JP, Schmid CH. Quantitative synthesis in systematic reviews. Ann Intern Med. 1997;127:820–826
  14. Tønnesen 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
  15. Yokota T, Uehara K, Nomoto Y. Intrathecal morphine suppresses NK cell activity following abdominal surgery. Can J Anaesth. 2000;47:303–308
  16. Volk T, Schenk M, Voigt K, Tohtz S, Putzier M, Kox W. Postoperative epidural anesthesia preserves lymphocyte, but not monocyte, immune function after major surgery. Anesth Analg. 2004;98:1086–1092
  17. Ahlers O, Nachtigall I, Lenze J, et al. Intraoperative thoracic epidural anaesthesia attenuates stress-induced immunosuppression in patients undergoing major abdominal surgery. Br J Anaesth. 2008;101:781–787
  18. Pirtikkangas CO, Salo M, Riutta A, Perttilä J, Peltola O, Kirvela O. Effects of propofol and Intralipid on immune response and prostaglandin E2 production. Anaesthesia. 1995;50:317–321

☆ 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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