engleski

Early immunological events in postoperative epidural/intravenous analgesia after colorectal cancer resection

Background and purpose: Postoperative pain is a common consequence of extensive surgery with activation of the nervous system for the implementation of pain (nociceptive system), tissue injury or inflammation. As a result of tissue injury, many different mediators are released from damaged tissues, immunocompetent cells, sympathetic and sensory fibers which directly or indirectly activate nociceptors. Postoperative pain leads to suppression of the immune system, including reduced activity of NK cells, cytotoxic T lymphocytes and macrophages. Patients and Methods: We examined the effects of epidural and intravenous analgesia in patients after colorectal cancer surgery on the immune system. We analyzed the phenotype of isolated peripheral blood mononuclear cells of patients during first six postoperative days by flow cytometry and compared them with healthy volunteers. Results: Application of intravenous analgesia leads to statistically significant decreasing in the percentage of cells of innate immunity in comparison with them after epidural analgesia. Intravenous analgesia has led to a statistically significant reduction of subpopulation of T lymphocytes (CD3+) and B lymphocytes (CD19+) on the 6th postoperative day compared to epidural analgesia. Conclusion: Intravenous analgesia after colorectal cancer surgery has led to a statistically significant greater depression of innate and acquired immunity in comparison to epidural analgesia.

cellular immunity; colorectal cancer; epidural analgesia; intravenous analgesia; humoral immunity

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