The effects of epidural anaesthesia and analgesia on natural killer cell cytotoxicity and cytokine response in patients with epithelial ovarian cancer undergoing radical resection

Abstract

OBJECTIVE: Epidural anaesthesia appears to promote antitumourigenic activity in patients with malignant disease who are undergoing surgery. This study investigated immune function in women with epithelial ovarian cancer undergoing radical resection with either general anaesthesia alone or in combination with epidural anaesthesia. METHODS: Patients (n = 61) were randomized to receive either combined general/epidural anaesthesia (study group) or general anaesthesia alone (control group). Natural killer cell cytotoxicity (NKCC) and serum concentrations of four cytokines (interleukin [IL]-1b, -8 and -10 and interferon [IFN]-g) were measured before anaesthesia (Tpre) and 4 h after skin incision (T4 h) in both groups. RESULTS: In both groups, concentrations of protumourigenic cytokines (IL-1b and IL-8) were significantly higher at T4 h than at Tpre, while concentrations of antitumourigenic cytokines (IL-10 and IFN-g) and NKCC were significantly lower at T4 h. The study group had significantly higher NKCC, IL-10 and IFN-g levels and lower IL-1b and IL-8 levels at T4 h compared with the control group. CONCLUSION: Combined general/epidural anaesthesia appeared to promote antitumourigenic NKCC and cytokine responses.