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Result of a randomized clinical trial comparing different types of anesthesia on the immune function of patients with osteosarcoma undergoing radical resection.
AIM: The purpose of this article was to explore the effects of different anesthesia drugs and techniques on the immune function of patients with osteosarcoma around the knee undergoing radical resection.
METHODS: Forty-five ASA (American Society of Anesthesiologists) I-II patients were randomized and divided into three groups: the epidural anesthesia group (Group A), the general anesthesia group (Group B), and the combination of epidural anesthesia and general anesthesia group (Group C). The populations of T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and a possible association between these variables were investigated 2 h before anesthesia, before and after skin incision, and on the 1st, 3rd and 5th days after operation.
RESULTS: The serum sIL-2 levels and T lymphocyte subset populations did not show significant differences among the three groups before anesthesia and skin incision. Serum sIL-2R increased 2 h after skin incision and on the 1st and 3rd day after operation in groups A and B (P < 0.01), and was higher than that of group C 2 h after skin incision and on the 1st day after operation (P < 0.01). Serum sIL-2R increased on the 1st postoperative day in group C. The CD3+, CD4+ and CD4+/CD8+ populations decreased significantly in all groups 2 h after skin incision, and on the 1st and 3rd days after operation (P < 0.05). However, in group C, CD4+/CD8+ levels had almost returned to baseline values on the 3rd day after operation (P > 0.05), and were significantly higher than those of groups A and B (P < 0.05). On the 5th day after operation, CD3+, CD4+ and CD4+/CD8+ levels had returned to baseline values before anesthesia in group C (P > 0.05), and were significantly higher than those of groups A and B (P < 0.05).
CONCLUSION: Epidural anesthesia combined with general anesthesia might reduce the stress reaction and the effect of anesthetic drugs on sIL-2 levels and T lymphocyte subsets, contributing to the restoration of immune function in cancer patients.
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