Comparative Study of Immunologic Parameters between Spinal and Epidural Anesthesia for a Cesarean Section.
10.4097/kjae.2001.41.3.302
- Author:
Myung Hee KIM
1
;
Duck Hwan CHOI
;
Yeong Lan KANG
Author Information
1. Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Comparative Study ; Original Article ; Randomized Controlled Trial
- Keywords:
epidural;
spinal;
T helper cell;
cytokines;
cesarian section
- MeSH:
Anesthesia;
Anesthesia, Epidural*;
Anesthesia, Spinal;
Cesarean Section*;
Cytokines;
Female;
Humans;
Immunosuppression;
Interferons;
Interleukin-10;
Interleukin-2;
Interleukin-4;
Lymphocytes;
Pregnancy;
T-Lymphocytes, Helper-Inducer
- From:Korean Journal of Anesthesiology
2001;41(3):302-310
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Surgical stress and anesthesia can cause postoperative immunosuppression. T helper lymphocytes play a central role in the immune response. Cytokines secreted from T helper type-1 (Th1) and Th2 influence patients' morbidity. The purpose of the current study was to compare the effect of spinal anesthesia with epidural anesthesia on the T helper cell and cytokine secretions following cesarean section. METHODS: Forty-four patients were randomly divided into two groups. Total lymphocytes, T helper cells, and T helper type-1 and type-2 cytokines, interleukin-2 (IL-2), interferon gamma (IFN-gamma), and IL-4 and IL-10 in the supernatant of CD4 cells stimulated with phytohemagglutinin were identified by using an enzyme-linked immune assay. Blood samples were obtained before surgery, 1, 3, and 24 h after the start of surgery. RESULTS: Significant decreases in lymphocytes and CD4 cells at 3 and 24 h after the start of surgery were seen in epidural anesthesia. The Th1 response, IFN-gamma and IL-2 secretions were detected in 9 patients, in the spinal group, and 9 and 14 patients in the epidural group, respectively. There were no differences in the Th1 responses between the groups as well as within the groups. Th2 cytokine, IL-10 response in the higher concentration group receiving spinal anesthesia decreased significantly over the three time points studied, but decreased only at 24 h in the epidural group. CONCLUSIONS: Our results show a possible different immune response profile between the spinal and epidural group: a decreased CD4 level in the epidural group and decreased IL-10 levels in the spinal group according to the time period after surgery.
