Differences in the suppression of immune response between general anesthesia and spinal anesthesia in femoral bone surgery

Abstract

Anesthesia is an effective way to control stress response. Surgical injury, different anesthesia techniques, and related drugs can directly or indirectly affect the immune system. The perioperative immunosuppression observed in surgical patients is associated with the neuroendocrine stress exerted through the activation of the autonomic nervous system and the hypothalamic-pituitary-adrenal axis. Dysregulation of this inflammatory process may increase susceptibility to infections and result in postoperative complications, such as wound-healing disturbances and infections leading to sepsis. In this case report which enrolled six patients who underwent femoral bone surgery, three patients were under general anesthesia and three patients were under regional anesthesia. We found that increased neutrophil count and serum C-reactive protein (CRP) concentration were lower in patients under spinal anesthesia compared to those under general anesthesia. In conclusion, the inflammatory response to surgery, which could be seen in the neutrophil count and CRP level, was suppressed during spinal anesthesia to a greater extent than during general anesthesia.