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| IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711 |
Int J Clin Exp Med 2013;6(8):716-719
Original Article
Combined general and regional anesthesia and effects on immune function in
patients with benign ovarian tumors treated by laparoscopic therapy
Yong-Chong Cheng, Xiao-Bin Cheng, Xin-Jie Li, Feng-Zhao Wang, Zhi-Kui Li
Department of Anesthesiology, Third Hospital of the Chinese Peoples Liberation Army, Baoji 721004, Shanxi Province, China;
Department of Respiratory, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shanxi Province, China
Received August 1, 2013; Accepted August 19, 2013; Epub September 1, 2013; Published September 15, 2013
Abstract: Objective: Anesthesia has been shown to suppress immune function, which can negatively affect the treatment of patients
with various tumors. Here, we assessed two different anesthesia methods, general versus combined regional/general, in treatment of
benign ovarian tumor by laparoscopic therapy. Methods: Out of 160 patients with benign ovarian tumors treated by laparoscopic
therapy, 80 received general anesthesia combined with thoracic epidural anesthesia during surgery, and 80 received general
anesthesia only. Venous blood samples were obtained at the following time points: before induction of anesthesia (T0), 2 hours after
anesthesia, during operation, 3 days (d) after operation, 5 d after operation, and 7 d after operation. Percentages of CD3+, CD4+, and
CD4+/CD8+ T lymphocytes were determined at these time points by flow cytometry to assess immune function. Results: For both
groups, percentages of CD3+, CD4+, and CD4+/CD8+ T cells decreased significantly from T0 to 2 hr after anesthesia (P < 0.05). These
percentages decreased again during surgery. However, T cell percentages in patients receiving combined anesthesia returned to
normal levels 5 d after surgery, and those receiving only intravenous anesthesia returned to normal by 7 d after surgery. There were no
significant differences in CD3+, CD4+, or CD4+/CD8+ T cell percentages between the two anesthesia groups at T0 and 7 d. However,
significant differences in these percentages were observed between the two groups at all other time points. Interestingly, the decrease
observed within the combined group were less dramatic than those observed within the intravenous-only group (P < 0.05).
Conclusions: These findings indicate that, while any anesthesia may suppress immune function of patients treated by laparoscopic
therapy, the effect of general anesthesia combined with thoracic epidural anesthesia on immune function was less than that produced
by general anesthesia alone. (IJCEM1308001).
Keywords: Epidural anesthesia, general anesthesia, ovarian tumor, laparoscopy, immune function
Address correspondence to: Dr. Zhi-Kui Li, Department of Respiratory, Xijing Hospital, Fourth Military Medical University, N0. 15
Changle West Road, Xi’an 710032, Shanxi Province, China. Tel: +86 29 84775233; E-mail: Lizk1963@yeah.net
Original Article
Combined general and regional anesthesia and effects on immune function in
patients with benign ovarian tumors treated by laparoscopic therapy
Yong-Chong Cheng, Xiao-Bin Cheng, Xin-Jie Li, Feng-Zhao Wang, Zhi-Kui Li
Department of Anesthesiology, Third Hospital of the Chinese Peoples Liberation Army, Baoji 721004, Shanxi Province, China;
Department of Respiratory, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shanxi Province, China
Received August 1, 2013; Accepted August 19, 2013; Epub September 1, 2013; Published September 15, 2013
Abstract: Objective: Anesthesia has been shown to suppress immune function, which can negatively affect the treatment of patients
with various tumors. Here, we assessed two different anesthesia methods, general versus combined regional/general, in treatment of
benign ovarian tumor by laparoscopic therapy. Methods: Out of 160 patients with benign ovarian tumors treated by laparoscopic
therapy, 80 received general anesthesia combined with thoracic epidural anesthesia during surgery, and 80 received general
anesthesia only. Venous blood samples were obtained at the following time points: before induction of anesthesia (T0), 2 hours after
anesthesia, during operation, 3 days (d) after operation, 5 d after operation, and 7 d after operation. Percentages of CD3+, CD4+, and
CD4+/CD8+ T lymphocytes were determined at these time points by flow cytometry to assess immune function. Results: For both
groups, percentages of CD3+, CD4+, and CD4+/CD8+ T cells decreased significantly from T0 to 2 hr after anesthesia (P < 0.05). These
percentages decreased again during surgery. However, T cell percentages in patients receiving combined anesthesia returned to
normal levels 5 d after surgery, and those receiving only intravenous anesthesia returned to normal by 7 d after surgery. There were no
significant differences in CD3+, CD4+, or CD4+/CD8+ T cell percentages between the two anesthesia groups at T0 and 7 d. However,
significant differences in these percentages were observed between the two groups at all other time points. Interestingly, the decrease
observed within the combined group were less dramatic than those observed within the intravenous-only group (P < 0.05).
Conclusions: These findings indicate that, while any anesthesia may suppress immune function of patients treated by laparoscopic
therapy, the effect of general anesthesia combined with thoracic epidural anesthesia on immune function was less than that produced
by general anesthesia alone. (IJCEM1308001).
Keywords: Epidural anesthesia, general anesthesia, ovarian tumor, laparoscopy, immune function
Address correspondence to: Dr. Zhi-Kui Li, Department of Respiratory, Xijing Hospital, Fourth Military Medical University, N0. 15
Changle West Road, Xi’an 710032, Shanxi Province, China. Tel: +86 29 84775233; E-mail: Lizk1963@yeah.net
