• Liping Wang, Si Liang, Hong Chen, Yang Xu, and Yu Wang.
• Department of Anaesthesiology, Harbin Medical University Cancer Hospital, No. 150 Haping Rd., Nangang District, Harbin, 150081, China.
• BMC Anesthesiol. 2019 Jun 12; 19 (1): 102.

BackgroundEpidural use can prevent peri-operative neuro-endocrine stress responses, mitigate pain after surgery, and reduce opioid use, which all lead to immunosuppression.MethodsForty patients with gastric cancer were ultimately enrolled into the study. Patients who received general anaesthesia (GA group, n = 20) or a combination of general anaesthesia and peri-operative epidural use (EGA group, n = 20) were given intravenous analgesia or epidural analgesia, respectively. We collected visual analogue scale (VAS) scores, length of hospital stay, the time of the first passage of flatus and incidence of postoperative nausea and vomiting (PONV). We also collected data on the cluster of differentiation markers (CD)3+, CD4+, CD8+, CD4+/CD8+, interleukin (IL)-4, IL-6, and interferon (IFN)-γ the day before surgery as well as on postoperative days 1, 3, and 7.ResultsVAS scores and PONV in the GA group were higher than in the EGA group on postoperative day 3. CD3+, CD4+, and CD4+/CD8+ T cells declined on postoperative day 3 and nearly recovered to baseline seven days after surgery in both groups. CD3+ T cells decreased more in the GA group than in the EGA group. IL-4, IL-6, and IFN-γ increased on postoperative day 3 and nearly recovered to baseline seven days after surgery in both groups. IL-4 and IL-6 increased more in the GA group than in the EGA group. IFN-γ increased more in the EGA group than in the GA group.ConclusionsA combination of general anaesthesia and peri-operative epidural use can relieve postoperative pain and PONV. A combination of general anaesthesia and peri-operative epidural use decreases immunosuppression in gastric cancer resection.Trial RegistrationThe study procedures were approved by the Ethics Committee of The Harbin Medical University Cancer Hospital. This study was registered prospectively at http://www.chictr.org.cn/index.aspx on October 10, 2017 (Registered ChiCTR-INR-17012939 ).

42 keywords...

hide…