Research output: Contribution to journal › Article › peer-review
The Immunosuppressive Effects of Volatile Versus Intravenous Anesthesia Combined With Epidural Analgesia on Kidney Cancer: A Pilot Randomized Controlled Trial. / Efremov, Sergey M. ; Kozireva, Victoria S. ; Moroz, Gleb B.; Abubakirov, Marat N.; Shkoda, Olga S. ; Shilova, Anna N.; Yarmoshuk, Sergey V. ; Zheravin , Alexandr A. ; Landoni, Giovanni; Lomivorotov, Vladimir V.
In: Korean Journal of Anesthesiology, Vol. 73, No. 6, 12.2020, p. 525-533.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - The Immunosuppressive Effects of Volatile Versus Intravenous Anesthesia Combined With Epidural Analgesia on Kidney Cancer: A Pilot Randomized Controlled Trial
AU - Efremov, Sergey M.
AU - Kozireva, Victoria S.
AU - Moroz, Gleb B.
AU - Abubakirov, Marat N.
AU - Shkoda, Olga S.
AU - Shilova, Anna N.
AU - Yarmoshuk, Sergey V.
AU - Zheravin , Alexandr A.
AU - Landoni, Giovanni
AU - Lomivorotov, Vladimir V.
PY - 2020/12
Y1 - 2020/12
N2 - Background: The aim of this study was to test the hypothesis that the suppression of the cell-mediated immunity is worse under the use of inhalational anesthesia as 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 anesthetic) or sevoflurane-based (volatile anesthetic) anesthesia group with 10 patients in each group, along with epidural analgesia in both the groups. Frequencies of natural killer 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 primary end point of the study was natural killer (NK) cell count and the secondary end point was the total T lymphocyte count and cell counts for T lymphocyte subpopulations.Results: Our study showed that there were no significant differences in the frequency of NK cells, total T lymphocytes, regulatory T cells, and T-helper cells, cytotoxic T lymphocytes, and their subpopulations between the propofol-based and sevoflurane-based anesthesia group, when the anesthesia was administered in combination with epidural analgesia.Conclusions: The results of the current pilot study did not support the hypothesis that the suppression of the cell-mediated immunity is worse under the use of inhalational anesthesia as compared to 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 suppression of the cell-mediated immunity is worse under the use of inhalational anesthesia as 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 anesthetic) or sevoflurane-based (volatile anesthetic) anesthesia group with 10 patients in each group, along with epidural analgesia in both the groups. Frequencies of natural killer 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 primary end point of the study was natural killer (NK) cell count and the secondary end point was the total T lymphocyte count and cell counts for T lymphocyte subpopulations.Results: Our study showed that there were no significant differences in the frequency of NK cells, total T lymphocytes, regulatory T cells, and T-helper cells, cytotoxic T lymphocytes, and their subpopulations between the propofol-based and sevoflurane-based anesthesia group, when the anesthesia was administered in combination with epidural analgesia.Conclusions: The results of the current pilot study did not support the hypothesis that the suppression of the cell-mediated immunity is worse under the use of inhalational anesthesia as compared to 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
KW - Anesthesia
KW - KILLER-CELL CYTOTOXICITY
KW - SURGERY
KW - SURVIVAL
KW - APOPTOSIS
KW - NEURAXIAL ANESTHESIA
KW - SERUM
KW - BREAST-CANCER
KW - RECURRENCE
UR - https://ekja.org/journal/view.php?doi=10.4097/kja.19461
UR - http://www.scopus.com/inward/record.url?scp=85096951771&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/a136687c-8137-3a54-bcbb-06ac88d91ebf/
U2 - 10.4097/kja.19461
DO - 10.4097/kja.19461
M3 - Article
C2 - 32098012
VL - 73
SP - 525
EP - 533
JO - Korean Journal of Anesthesiology
JF - Korean Journal of Anesthesiology
SN - 2005-6419
IS - 6
ER -
ID: 53902059