Naslov
Spinalna Anestezija i Imuni odgovor na stres
(Spinal Anesthesia and Stress/Immune Response)

Autori
Šakić, Kata

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstracts of The ..... ; u: Regional anesthesia and pain medicine 40 (2015) ESRAS-0527 / - , 2015, E65-e67

Skup
The .....

Mjesto i datum
XX, XXX, Xx.-xx.xx.20015

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
spinalna anestezija ; stresni odgovor
(spinal anaesthesia ; stress response)

Sažetak
Stress response is a significant risk factor for an unsatisfactory outcome in surgical patients. This is part of the systemic reaction to injury which encompasses a wide range of endocrinological, immunological and hematological effects. The reduction and modulation of stress response during the operation can significantly reduce the incidence of post-operative complications and morbidity. Regional anesthesia with local anesthetic agents inhibits the stress response to surgery and can also influence postoperative outcome by beneficial effects on organ function. Different anesthesia methods do not have the same effect on clinical outcome regarding their efficacy in suppressing this stress. A combination of the analgesic methods could bemore effectivewhile having fewer adverse effects of the anesthetics. The results of the current study suggested that spinal anesthesia plus intravenous patient-controlled analgesia have themost favorable cardiac effects regarding postoperative levels of pro-BNP.Indeed it seems that spinal anesthesia results in less immunosupression compared to general anesthesia, i.e. maintains the number of Th1 cells, thus stimulating the cell immunology. Cytokines are significant mediators of the immune response to surgery. Žura et al. showed on a case series an increase of pro-inflammatory cytokine IL-6 on first postoperative day after spinal anesthesia for transurethral resection of the prostate. Another study of the same authors on more significant number of patients confirmed surgery-related postoperative release of the pro-inflammatory cytokine IL-6 was increased in patients after spinal and general anesthesia. In addition, increased levels of the typical Th1 cytokine IL-2 were found in patients anesthetized by general anesthesia compared to spinal anesthesia. Serum concentrations of other proinflammatory cytokines, anti-inflammatory cytokines and cytokines which are secreted by Th1 helper lymphocytes showed no statistical difference before and after surgery under general and spinal anesthesia.Hemostasis changes can be considered as a component of the surgical stress-response too. Liuboshevskiĭ et al. claimed that the role of intraoperative regional anesthesia was much more significant, than postoperative analgesia. Both spinal and epidural anesthesia show comparable correction of surgical stress-response markers. Also both types of regional anesthesia reduced hypercoagulation expression and prevented fibrinolysis activation. This resulted in a reduction in the hemotransfusion frequency. Administration of local anesthetics was designed to provide intraoperative anesthesia and analgesia. However, in recent years it has become evident and clear that regionally administrated local anesthetics have benefits far beyond anesthesia and pain relief ; indeed the technique has significant impact on outcome of major surgical procedures by modulating stress/immune response.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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