Thoracic Epidural Anaesthesia Was Not Able to Attenuate Stress-Induced Immunosuppression in Patients Undergoing Major Abdominal Surgery

Background: Blunting the perioperative stress response and preserving immune function are critical issues for patients undergoing major abdominal surgery. Aim: The present study investigated whether perioperative thoracic epidural block affects postoperative immune response in patients undergoing major abdominal surgery. Patients and Methods: Patients undergoing major abdominal surgery were randomly assigned to either general anesthesia with continuous epidural infusion via epidural catheters that was continued for postoperative analgesia (group E, n=15) or intraoperative general anesthesia and postoperative IV morphine analgesia (group G, n=15). Plasma levels of Creactive protein (CRP), leukocyte counts, and percentage of total lymphocytes were assessed before and after surgery and on postoperative days (PODs) 1 and 3. Results: There were no significant differences in variables between groups. In both groups, Leukocyte counts were increased on POD1 (each group p 0.05) and POD3 (each group p 0.01). The proportion of lymphocytes decreased from the end of surgery to POD3 (each group p 0.01) and CRP were still increased on POD1 and POD3 (each change, each group p 0.01). Conclusion: Tissue damage and inflammation apparently overcome the effects of thoracic epidural block on stress-induced immunosuppression in patients undergoing major abdominal surgery.