A study on cellular immune function of patients treated with radical resection of pulmonary carcinoma with two different methods of anesthesia and analgesia.

PURPOSE

To compare the influence on the immune system of two different methods of anesthesia and analgesia in patients treated with radical resection of pulmonary carcinoma.

METHODS

Thirty-four patients treated with radical resection of pulmonary carcinoma were randomly divided into two groups (group A and group B, 17 cases in each group). Patients in group A were administered total intravenous anesthesia (TIVA) without inhaled hypnotics and intravenous analgesia while patients in group B were administered TIVA combined with epidural anesthesia and epidural analgesia. We compared changes of the T cells subsets (CD3+, CD4+, CD8+ and CD4+/CD8+ ratio) and the function of natural killer (NK) cells in patients at 4 time points: before anesthesia, immediately after surgery, 24 hrs after surgery and 72 hrs after surgery. Clinical data were also collected.

RESULTS

CD8+ in group A and B was significantly increased (p<0.01) while the other indexes CD3+, CD4+, CD4+/CD8+ ratio and NK cells) were significantly decreased (p<0.05). There was a significant difference in various indexes (except NK cell) before anesthesia and 72 hrs after surgery in group A (p<0.01). Various indexes of patients in group B at 72 hrs after surgery were restored to the values before anesthesia (p>0.05). We observed a significant difference in CD3+, CD8+ and CD4+/CD8+ indexes in groups A and B patients at 72 hrs after surgery (p<0.05).

CONCLUSIONS

TIVA combined with epidural anesthesia and epidural analgesia demonstrated less interference with the immune system and determine fast recovery in patients with radical resection of pulmonary carcinoma.