British Journal of Anaesthesia, 1994, Vol. 73, No. 3 318-321
© 1994 The Board of Management and Trustees of the British Journal of Anaesthesia
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Effects of hydrocortisone and adrenaline on natural killer cell activity
Department of Anaesthesiology, Kanto Rosai Hospital 2035 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki-city, Kanagawaken 211, Japan
Correspondence to Y. N.
We have studied the effects of hydrocortisone and adrenaline on natural killer (NK) cell activity and on the distribution of circulating lymphocyte sub-populations in 30 patients undergoing elective partial laminectomy under general anaesthesia. The patients were allocated to receive adrenaline (group 1, n = 11), hydrocortisone and adrenaline (group 2, n = 11) or neither hydrocortisone nor adrenaline (group 3, n = 8). Group 1 and group 2 patients received local adrenaline infiltration during operation to reduce bleeding. The mean dose of adrenaline administered was 2.1 (SD 0.2) µg kg–1 Group 2 received hydrocortisone 10 mg kg–1 i.v. after premedication. In groups 1 and 2, adrenaline produced an instantaneous increase in NK cell activity accompanied by a selective increase in circulating NK cells. The measurements returned to pre-infiltration levels within 120 min of administration of adrenaline. The effect of adrenaline in causing increased NK cell activity was not blocked by pre-administration of hydrocortisone. There was a significant decrease in the ratio of T helper/inducer cells (CD4) to T-suppressor/ cytotoxic cells (CD8) in all patients after induction of anaesthesia. In groups 1 and 3, the CD4/CD8 cell ratio did not change significantly during operation. However, compared with groups 1 and 3, group 2 showed a significantly reduced CD4/CD8 cell ratio during operation. Therefore, these results suggest that even in cases of such severe stress that the immune response was depressed by increased serum cortisol concentrations, adrenaline-induced NK cell activity enhancement was preserved.
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