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 -