Purpose: The effects of morphine on natural killer (NK) cell activity were investigated in patients who underwent hysterectomy.Methods: Forty patients were divided into four groups of ten. The groups received intrathecal 0.5 mg morphine (Group IT 0.5 ), intrathecal 0.1 mg morphine (Group IT 0.1 ) or 10 mg morphine iv (Group IV). The remaining ten patients served as controls and received inhalation anesthesia alone (Group C). Blood samples were withdrawn before and two hours after surgery and on postoperative days one and two to determine the blood NK cell activity using a chromium release assay with K562 cells as targets, plasma catecholamines and cortisol levels. The postoperative pain score and side effects were studied in the four groups.Results: In Group IT 0.5 , the NK cell activity was lower on postoperative day 1 (23.9 ± 8.4%) than the baseline level (45.7 ± 13%) before surgery, and recovered on postoperative day 2. In Groups IT 0.1 , C and IV, the NK cell activities showed no significant changes. In all four groups, neither plasma adrenaline nor noradrenaline concentrations changed. In all four groups, the plasma cortisol levels increased after surgery, on postoperative days 1 and 2. The pain score was lower two hours after surgery and on postoperative day 1 in Group IT 0.5 than in the other groups. Conclusion:These results suggest that long-lasting analgesic effects of intrathecal 0.5 mg morphine suppress the immune response following abdominal surgery.Objectif : Les effets de la morphine sur l'activité des cellules tueuses naturelles (NK) a été examinée chez des patientes qui devaient subir une hystérectomie.Méthode : Quarante patientes ont été réparties en quatre groupes de dix. Elles ont reçu 0,5 mg de morphine en administration intrathécale (Groupe IT 0,5 ), ou 0,1 mg de morphine intrathécale (Groupe IT 0,1 ) ou 10 mg de morphine iv (Groupe IV). Les dix dernières patientes ont constitué le groupe témoin et n'ont reçu qu'une anesthésie par inhalation (Groupe T). Les prélèvements sanguins ont eu lieu avant l'intervention et deux heures après, et les premier et deuxième jours postopératoires afin de déterminer l'activité sanguine des cellules NK, en utilisant un dosage de la libération de chrome avec des cellules K562 comme cibles, les niveaux plasmatiques de catécholamines et de cortisol. Les scores de douleur postopératoire et les effets secondaires ont été étudiés chez toutes les patientes.Résultats : Dans le Groupe IT 0,5 , l'activité des cellules NK a été plus faible au premier jour postopératoire (23,984 %) qu'au niveau de base (45,713 %) déterminé avant l'opération, mais a retrouvé cette valeur au jour 2. Dans les Groupes IT 0,1 , T et IV, l'activité des cellules NK n'a pas été modifiée de façon significative. Dans les quatre groupes, les concentrations plasmatiques d'adrénaline ou de noradrénaline n'ont pas changé et les niveaux de cortisol plasmatique se sont accrus après l'opération aux jours 1 et 2. Le score de douleur a été plus bas dans le Groupe IT 0,5 que dans les autres groupes, deux he...

Intrathecal administration of morphine causes a decrease in NK cell activity, and its combined use with noradrenaline prolongs the suppression of NK cell activity.

The effects of nitroglycerin, dopamine and dobutamine on pulmonary gas exchange were determined in 21 adult patients during decreased cardiac index (CI)

Vital capacity inhalation of 8% sevoflurane produces a faster loss of eyelash reflex than does 5% sevoflurane or propofol, but increases cerebral blood volume.

The distribution of pnlmonz~ry hlood fiow was measured in supine patients before surgery by meom of lung pe~usion scanning with 99'nTc-macroaggre gated albumin in an attempt to predict values of Pa02 during subsequen2 one-lung anaesthesia. The Pa02 values during one-lung anaesthesia were well correlated with the preoperative lung perfusion partition ratios (r = 0.84, p < 0.05). In 9 of4Opat&nts, Pa02 was < 80 mmHg during one.lung ventilation (FRO2 0.99). In these patients the lung perfusion ratios of the dependent lung were as low as 41.0-48.2 per cent. These results indicate that preoperative measurement of pulmonary, blood flow can predict values of Pa02 during one-lung anaesthesia. Severe hypoxaemia develops occasionally during onelung anaesthesia. Peltola ~ reported that during one-lung ventilation, 6 of 32 patients had PaO2 values less than 70mmHg, in spite of breathing 10t') per cent oxygen (lowest value 52.4mmHg). Katz etal. 2 reported that one-lung ventilation with an FmO: of 0.99 resulted in a PaO2 of less than 80 mmHg in 5 of 17 patients and in two patients PaO2 was less than 60mmHg. In this study, the distribution of preoperative pulmonary blood flow was measured by means of lung perfusion scanning with 99r~Tc-macroaggregated-alhumin (99mTc-MAA) in an attempt to predict values of PaO2 during subsequent one lung anaesthesia. Methods The investigation was perfon~led in 40 adult patients between the ages of 27 and 74 years undergoing elective thoracotomy, Surgery was for cancer of the lung in 26 patients, empyema in eight patients and pulmonary tuberculosis in six patients. Following intravenous injection of approximately