engleski

THE CHARACTERISTICS OF POSTOPERATIVE EPIDURAL ANALGESIA ON IMMUNOLOGICAL STATUS OF PATIENTS WITH COLORECTAL CARCINOMA

Background and aims: The quality of recovery after surgical procedures depends on various stimuli, including the quality of postoperative pain relief, hemodynamic and respiratory status of patients, as well as possible anti-nociceptive-associated side effects, as nausea and vomiting. Oncologic patients may suffer varying degrees of pain and this pain may cause the changes in immunological parameters of our patients. The purpose of this study was to examine the changes in innate and acquired immune response in peripheral blood of patient after resection of colorectal carcinoma when postoperative pain is reduced by epidural analgesia. Methods: Human peripheral blood mononuclear cells (PBMNC) from healthy adult volunteers and from patients with colorectal carcinoma, classified as Dukes’ B or Dukes’ C, were taken before the operation and during the postoperative epidural analgesia on the 1st, 2nd and 6th postoperative day and were labeled with antibodies by direct or indirect staining. CD3, CD4, CD8, CD16, CD+56, NKT cells, T cells, NK cells, regulatory T cells (Tregs) and B cells (CD19). Results: The results indicate that the percentage of CD4, CD19, double staining CD3/CD4, CD3/CD8 and CD5/CD19 positive cells are significantly decreased in CA patients, while the percentage of NKT and Treg cells has shown significant augmentation. These proportions depend of the status of illness and distinguish between the first and the 6th postoperative day. The first day all examine values are significantly decreased. Conclusions: Postoperative epidural analgesia very quickly modifies the innate immune response, but not the cellular immunity. Acknowledgment: This work was supported by grants from the Croatian Ministry of Science (projects: 0620096-0092 and 0620096-0094)

cellular immunity; postoperative analgesia; colorectal carcinoma

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