General/epidural anesthesia in combination preserves NK cell activity and affects cytokine response in cervical carcinoma patients undergoing radical resection: a cohort prospective study

Abstract

Objective: Emerging evidence has shown that epidural anesthesia may help to preserve the body's defenses against tumor progression in comparison with general anesthesia in malignant patients receiving operation. This study aims to evaluate the effect of epidural anesthesia on postoperative immune suppression in cervical carcinoma patients undergoing radical resection.

Materials and methods: Eighty five cervical carcinoma patients receiving radical resection were randomized to combined general/epidural anesthesia (study group) or general anesthesia alone (control group). Natural killer (NK) cell activity and serum concentrations of protumorigenic cytokines (IL-1β, IL-6, and 1L-8) and antitumorigenic cytokines (IL-2 and IFN-γ) were measured before anesthesia (T1), four hours after skin incision (T2), and 24 hours after skin incision (T3) in both groups.

Results: No difference was observed in basal NK cell activity and cytokine concen- trations between study and control groups. The study group exhibited less suppression of NK cell activity, higher levels of IL-2 and IFN-γ, and lower levels of IL-1β, IL-6, and IL-8 at T2 and T3 compared with the control group.

Conclusions: Combined general/epidural anesthesia seems to be helpful to maintain the body's perioperative immune function compared to general anesthesia alone in cervical carcinoma patients receiving operation.