The immunosuppressive effects of volatile versus intravenous anesthesia combined with epidural analgesia on kidney cancer : A pilot randomized controlled trial. / Efremov, Sergey Mihailovich; Kozireva, Victoria Sergeevna; Moroz, Gleb Borisovich et al.
In: Korean journal of anesthesiology, Vol. 73, No. 6, 12.2020, p. 525-533.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - The immunosuppressive effects of volatile versus intravenous anesthesia combined with epidural analgesia on kidney cancer
T2 - A pilot randomized controlled trial
AU - Efremov, Sergey Mihailovich
AU - Kozireva, Victoria Sergeevna
AU - Moroz, Gleb Borisovich
AU - Abubakirov, Marat Nikolaevich
AU - Shkoda, Olga Sergeevna
AU - Shilova, Anna Nikolaevna
AU - Yarmoshuk, Sergey Valeriyevich
AU - Zheravin, Alexandr Alexandrovich
AU - Landoni, Giovanni
AU - Lomivorotov, Vladimir Vladimirovich
N1 - Publisher Copyright: © The Korean Society of Anesthesiologists, 2020. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - Background: The aim of this study was to test the hypothesis that the use of inhalational anesthesia leads to higher suppression of the cell-mediated immunity compared to total intravenous anesthesia in patients undergoing kidney cancer surgery under combined low thoracic epidural analgesia and general anesthesia. Methods: Patients were randomly allocated to either propofol-based (intravenous anes-thetic) or sevoflurane-based (volatile anesthetic) anesthesia group with 10 patients in each group, along with epidural analgesia in both groups. Amounts of natural killer (NK) cells, total T lymphocytes, and T lymphocyte subpopulations in the blood samples collected from the patients before surgery, at the end of the surgery and postoperative days 1, 3 and 7 were determined by flow cytometric analysis. The NK cell count served as the primary endpoint of the study, whereas the total T lymphocyte count and cell counts for T lympho-cyte subpopulations were used as the secondary endpoint. Results: Our study showed that there were no significant differences in the amount of NK cells, total T lymphocytes, regulatory T cells, and T-helper cells, cytotoxic T lymphocytes, and their subpopulations between the propofol-and sevoflurane-based anesthesia groups when the anesthesia was administered in combination with epidural analgesia. Conclusions: The results of this pilot study did not support the hypothesis that the use of inhalational anesthesia leads to higher suppression of the cell-mediated immunity than that of total intravenous anesthesia in patients undergoing kidney cancer surgery under combined low thoracic epidural analgesia and general anesthesia.
AB - Background: The aim of this study was to test the hypothesis that the use of inhalational anesthesia leads to higher suppression of the cell-mediated immunity compared to total intravenous anesthesia in patients undergoing kidney cancer surgery under combined low thoracic epidural analgesia and general anesthesia. Methods: Patients were randomly allocated to either propofol-based (intravenous anes-thetic) or sevoflurane-based (volatile anesthetic) anesthesia group with 10 patients in each group, along with epidural analgesia in both groups. Amounts of natural killer (NK) cells, total T lymphocytes, and T lymphocyte subpopulations in the blood samples collected from the patients before surgery, at the end of the surgery and postoperative days 1, 3 and 7 were determined by flow cytometric analysis. The NK cell count served as the primary endpoint of the study, whereas the total T lymphocyte count and cell counts for T lympho-cyte subpopulations were used as the secondary endpoint. Results: Our study showed that there were no significant differences in the amount of NK cells, total T lymphocytes, regulatory T cells, and T-helper cells, cytotoxic T lymphocytes, and their subpopulations between the propofol-and sevoflurane-based anesthesia groups when the anesthesia was administered in combination with epidural analgesia. Conclusions: The results of this pilot study did not support the hypothesis that the use of inhalational anesthesia leads to higher suppression of the cell-mediated immunity than that of total intravenous anesthesia in patients undergoing kidney cancer surgery under combined low thoracic epidural analgesia and general anesthesia.
KW - Anesthesia
KW - Cancer
KW - Epidural analgesia
KW - Immunity
KW - Propofol
KW - Sevoflurane
UR - http://www.scopus.com/inward/record.url?scp=85096951771&partnerID=8YFLogxK
U2 - 10.4097/kja.19461
DO - 10.4097/kja.19461
M3 - Article
C2 - 32098012
AN - SCOPUS:85096951771
VL - 73
SP - 525
EP - 533
JO - Korean journal of anesthesiology
JF - Korean journal of anesthesiology
SN - 2005-6419
IS - 6
ER -
ID: 26167164