Postoperative Epidural Analgesia Restores the Immune System of Patients after Total Knee Replacement

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Postoperative Epidural Analgesia Restores the Immune System of Patients after Total Knee Replacement

As per recent research conducted in the Department of Anesthesiology and Intensive Care Medicine, Lovran, Croatia, the postoperative regional analgesia helps to maintain cell-mediated immunity and perforin expression in peripheral blood lymphocytes in patients after Total knee replacement (TKR).

Surgical stress and pain after the surgical treatment initiate a pro-inflammatory response which leads to decrease body immunity. The low immunity may enhance postoperative complications like lengthening of wound healing and infections. Two components of cellular immunity; natural killer (NK) cells and T lymphocytes play an essential role in maintaining immunity.

Sandra Velcic Brumnjak and colleagues conducted the study to assess the effects of 3 types of postoperative analgesia on the preservation and cytotoxic potential of T lymphocytes, NK cells, and their subpopulations, as well as NKT cells, in patients after TKR to rule out the most efficient analgesic technique for decreasing immune suppression. 

A total of 40 patients were chosen for the analysis. These patients were randomly assigned to three groups. Patients in the Group one obtained epidural analgesia; Group two patients obtained femoral and sciatic nerve block and Group three received systemic multi-modal analgesia. The pain was measured before, immediately after surgery, 24 h, and 72 h post-treatment. At the same time point, blood samples were accumulated for peripheral blood mononuclear cells isolation. Flow cytometry was used to detect and assess NKT, NK and T lymphocytes frequencies along with their perforin expression.

A significant reduction in pain severity was noted in group 1 and 2 as compared to group 3. The  NKT, NK and T lymphocytes frequencies along with their perforin expression were considerably higher in group 1 and 2 as compared to group 3. The group one exhibited better outcomes as compared to the other two groups and this reflects a considerable efficacy of regional epidural anesthesia.

Source

Med Sci Monit            

Link to the Source:

http://www.ncbi.nlm.nih.gov/pubmed/30063033

The original title of the article:

Postoperative Regional Analgesia Is Effective in Preserving Perforin-Expressing Lymphocytes in Patients After Total Knee Replacement

Authors:

Sandra Velcic Brumnjak et al.

SearchTags: 
Therapeutic, Knee Osteoarthritis, Knee, Regional Analgesia, Systemic Multi-modal Analgesia, Efficacy
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