The In Vivo Effects of General and Epidural Anesthesia on Human Immune Function

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Abstract
Impaired in vivo immunity is often observed after major surgery and is multifactorial. We conducted a random- ized clinical study to determine the independent effects of general anesthesia (GA) and of lumbar epidural an- esthesia (LEA) on human immune function in the ab- sence of surgical trauma. Nineteen healthy volunteers were randomized to receive GA with thiopental and isoflurane, LEA with lidocaine, or no anesthesia (Control). Serial blood samples were tested for anti- body responses to antigen inoculation, neutrophil and mononuclear cell antibody-dependent cell cyto- toxicity (ADCC), natural killer cell cytotoxicity, and neutrophil phagocytic activity. Antibody responses were similar in the three groups. Mononuclear cell ADCC increased in the LEA group at the end of the anesthetic (P , 0.05 at effector/target (E/T) ratios of 10:1, 25:1, and 50:1). Natural killer cell cytotoxicity increased at the end of the anesthetic in both the LEA group (P , 0.05 at all E/T ratios) and the GA group (P , 0.05 at an E/T ratio of 5:1 and 10:1). No significant changes were observed for neutrophil ADCC or phagocytosis. General or epidural anesthesia alone, in the absence of surgery, seems to have only tran- sient and minor effects on human immune function. (Anesth Analg 2001;93:460 -5)