Kho H G, Van Egmond J, Eijk R J, Kapteyns W M
Institute for Anaesthesiology, University of Nijmegen, The Netherlands.
Eur J Anaesthesiol. 1991 Jan;8(1):39-45.
The changes in immunoglobulins (IgA, IgG and IgM) and total and differential leucocyte counts in the peripheral blood during, and for 6 days after, surgery were evaluated in 29 male patients submitted to standardized upper-abdominal surgery performed under two different anaesthetic techniques. Group 1 received stimulation of ear and paravertebral points, supplemented by small doses of fentanyl (mean 1.2 micrograms kg-1, range 0.0-5.7) and Group 2 received moderate-dose fentanyl (mean 22.9 micrograms kg-1, range: 17.5-29.8). All were induced with thiopentone 5 mg kg-1, intubated after vecuronium 0.1 mg kg-1 and ventilated with 67% nitrous oxide in oxygen. Inhalation anaesthesia was not used. Surgery was followed by a fall in immunoglobulins, lymphocyte and eosinophil counts and a rise in leucocyte and neutrophil counts in both groups (P less than 0.01). No recovery was observed until the last assessment on Day 6 after surgery in IgA, IgG, leucocyte, neutrophil and lymphocyte counts in both groups, whereas IgM and eosinophil counts recovered by Day 4. Monocyte and basophil counts were unchanged in either group. Acupuncture and transcutaneous stimulation analgesia performed for major abdominal surgery did not influence the body's immune system either during or after surgery as measured by the concentrations of immunoglobulin and total and differential WBC counts.
对29例接受标准化上腹部手术的男性患者，在两种不同麻醉技术下，评估手术期间及术后6天外周血中免疫球蛋白（IgA、IgG和IgM）以及白细胞总数和分类计数的变化。第1组接受耳穴和椎旁穴位刺激，并辅以小剂量芬太尼（平均1.2微克/千克，范围0.0 - 5.7），第2组接受中等剂量芬太尼（平均22.9微克/千克，范围17.5 - 29.8）。所有患者均用5毫克/千克硫喷妥钠诱导，0.1毫克/千克维库溴铵后插管，并用67%氧化亚氮-氧气混合气体通气。未使用吸入麻醉。两组患者术后免疫球蛋白、淋巴细胞和嗜酸性粒细胞计数均下降，白细胞和中性粒细胞计数均上升（P < 0.01）。两组患者术后第6天最后一次评估时，IgA、IgG、白细胞、中性粒细胞和淋巴细胞计数均未恢复，而IgM和嗜酸性粒细胞计数在第4天恢复。两组单核细胞和嗜碱性粒细胞计数均无变化。通过免疫球蛋白浓度以及白细胞总数和分类计数测量，用于腹部大手术的针刺和经皮刺激镇痛在手术期间或术后均未影响机体免疫系统。
