Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

Direkt zur Navigaton springen.
Direkt zum Inhalt springen.

Navigation/Suche

Gewählte Publikation:

SHR Neuro Krebs Kardio Lipid Stoffw Microb

Cata, JP; Bauer, M; Sokari, T; Ramirez, MF; Mason, D; Plautz, G; Kurz, A.
Effects of surgery, general anesthesia, and perioperative epidural analgesia on the immune function of patients with non-small cell lung cancer
J CLIN ANESTH. 2013; 25(4): 255-262. Doi: 10.1016/j.jclinane.2012.12.007
Web of Science PubMed FullText FullText_MUG

Co-Autor*innen der Med Uni Graz: Kurz Andrea
Altmetrics:
Dimensions Citations:
Plum Analytics:
Scite (citation analytics):
Abstract:: Study Objective: To assess preoperative and postoperative immune function in patients undergoing surgical resection of non-small cell lung cancer during general anesthesia and postoperative epidural analgesia. Design: Observational single-center study. Setting: University-affiliated academic center. Patients: 24 adult, ASA physical status 3 and 4 patients with stage 1, 2, or 3 non-small cell lung cancer. No study patient received preoperative chemotherapy or radiation. Interventions: Patients underwent thoracotomy with general anesthesia and postoperative epidural analgesia. Measurements: Bispectral index monitoring, sevoflurane requirements, and intraoperative transfusions were recorded. Total fentanyl consumption and pain (verbal numeric rating scale) were recorded 24 hours after surgery. Preoperative and 24-hour postoperative natural killer cell percentage and function and percentages of natural killer T cells, T helper cells (CD4+), and cytotoxic T lymphocytes (CD8+) were measured. Plasma concentrations of the T(H)1 cytokine interleukin-2 and interferon-gamma and the T(H)2 cytokines interleukin-4 were measured at the same time points. Results: The percentage (preoperative, 13.07 +/- 9.81% vs postoperative, 9.6 +/- 6.57%, P < 0.001) and function (preoperative, 31.61 +/- 21.96%; postoperative, 13.61 +/- 9.36%; P < 0.001) of natural killer cells was significantly decreased after surgery, but the percentage of natural killer T cells, T helper cells (CD4+), and cytotoxic T lymphocytes (CD8+) remained unchanged postoperatively; thus, the CD4/CD8 ratio remained unchanged. Postoperative plasma concentrations of the three cytokines were similar to preoperative levels; therefore, the T(H)1/T(H)2 ratio also remained unchanged. Conclusions: Innate immunity is depressed in patients with non-small cell lung cancer after surgical resection, and immunity is not preserved by the use of postoperative epidural analgesia. (c) 2013 Elsevier Inc. All rights reserved.
Find related publications in this database (Keywords): Analgesia, epidural; Anesthesia; Innate immunity; Lung cancer; Natural killers non-small cell lung cancer