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.