OPEN IN READ APP
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

Effect of preemptive epidural analgesia on cytokine response and postoperative pain in laparoscopic radical hysterectomy for cervical cancer

Jeong-Yeon Hong, Kyung T Lim
Regional Anesthesia and Pain Medicine 2008, 33 (1): 44-51
18155056

BACKGROUND AND OBJECTIVE: Surgical stress and general anesthesia suppress immune function. Preemptive epidural analgesia can affect the perioperative immune responses, and influence cancer management.

METHODS: Forty women undergoing elective laparoscopic radical hysterectomy for cervical cancer were allocated to this prospective, randomized, double-blind trial. Before inducing anesthesia, 2 mg morphine dissolved in 15 mL of 1% lidocaine (preemptive group) or the same volume of normal saline (control group) was administered into the epidural space through a prepared catheter in a double-blind manner, using sealed syringes. After peritoneal closure, the other drugs in the remaining sealed syringe were administered in the reverse manner. All patients were then administered lidocaine plus morphine over a 72-hour period, using a patient-controlled epidural analgesia pump.

RESULTS: The interleukin-6 levels in both groups increased significantly after surgery. These elevations were significantly less pronounced in the preemptive group than in the control group. The interleukin-2 level in both groups decreased significantly after surgery. Seventy-two hours after surgery, the interleukin-2 level returned to its baseline value in the preemptive group but not in the control group. The number of lymphocytes in both groups decreased significantly after surgery. The pain scores at 6 and 12 hours after surgery in the preemptive group were significantly lower than in the control group.

CONCLUSIONS: Preemptive epidural analgesia is a reasonable approach for potentially controlling perioperative immune function and preventing postoperative pain in patients undergoing cancer surgery.

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
18155056
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"