INFLUENCE OF EXTRADURAL AND GENERAL ANAESTHESIA ON NATURAL KILLER CELL ACTIVITY AND LYMPHOCYTE SUBPOPULATIONS IN PATIENTS UNDERGOING HYSTERECTOMY

doi:10.1093/bja/60.5.500

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British Journal of Anaesthesia, 1988, Vol. 60, No. 5 500-507
© 1988 The Board of Management and Trustees of the British Journal of Anaesthesia

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INFLUENCE OF EXTRADURAL AND GENERAL ANAESTHESIA ON NATURAL KILLER CELL ACTIVITY AND LYMPHOCYTE SUBPOPULATIONS IN PATIENTS UNDERGOING HYSTERECTOMY

E. TØNNESEN, M.D.¹ and C. WAHLGREEN, M.D.²

¹Institute of Anaesthesiology and Department of Clinical Immunology, Odense University Hospital DK-5000 Odense C, Denmark
²Department of Anaesthesia, Odense University Hospital DK-5000 Odense C, Denmark

The effect of hysterectomy was studied on natural killer (NK)cell activity, the distribution of lymphocyte subpopulations,and the endocrine stress response in 16 patients allocated toreceive extradural analgesia S5-T4 (group I) or neuroleptanaesthesia(NLA) (group II). In group II a significant decrease in NK cellactivity was found after operation for at least 3 days, whilesurgery during extradural analgesia did not induce significantchanges. The impaired NK cell activity was accompanied by leucocytosisand lymphopenia affecting the T-lymphocytes (OKT3⁺ and OKT4⁺),the B-lymphocytes (B1⁺) and NK cells (Leu 11⁺). Compared withgroup II, extradural analgesia significantly reduced the cortisoland noradrenaline response to surgery, while the adrenalineresponse in both groups was abolished. The results suggest thatthe decrease in NK cell activity and alterations in lymphocytesubsets induced by surgery and general anaesthesia can be preventedto a certain degree by extradural analgesia.

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