Effects of anaesthesia and surgery on the immune response

Abstract

Alterations have been found to occur in every component of immune response during anaesthesia and surgery. These alterations represent the body's general physiological responses and are mainly dependent on the extent of surgery, as well as other factors such as the patient's age and health status, medication and blood transfusion. Anaesthetic and operative complications have profound effects on these responses. Basically, the immune response to anaesthesia and surgery is a beneficial reaction, needed in local host defences and wound healing and in preventing the body from making autoantibodies against its own tissues. The responses may, however, contribute to the development of postoperative infections and spread of malignant disease. During uncomplicated conventional surgery, the immune response usually passes clinically unnoticed without any harmful effects. Absent responses and excessively high responses, on the other hand, harm the patient. Our understanding of immunological phenomena and our possibilities of controlling mediator activation are now lagging behind the technical advances made in operative treatment. If we want to decrease operative morbidity and mortality to below their present levels, more attention should be directed to immune responses to major surgery, injuries and operative complications with massive mediator release which place the surgical patient at risk. Experimental evidence suggests that results of treatment in injured and operated patients can in the future be improved by controlling immune responses and their mediator systems. Our current level of knowledge of immune responses is already helping us to avoid many immune-mediated complications. However, routine interference with these responses is not indicated.

Naringenin reduces lung metastasis in a breast cancer resection model

“…Surgery may cause tumor cells to detach from primary tumors and disseminate throughout the body (van der Bij et al, 2008). Meanwhile, cell-mediated immunity is suppressed after surgery (Faist et al, 1986;Salo, 1992; Boomsma et al, Figure 3. Naringenin promotes T cell activation and restores T cell function in a tumor resection model.…”

Effect of tramadol on immune responses and nociceptive thresholds in a rat model of incisional pain

“…The immune system and different cytokines could be influenced by surgery (Salo, 1992;Hensler et al, 1997). In previous studies, it has been shown that the increase in concentration of IL-6 correlates well with operating time, severity of sepsis, and clinical complications after surgery (Damas et al, 1992).…”

“…Surgical trauma and anesthesia are associated with a complex dysregulation of the immune system and with the activation of both proinflammatory and anti-inflammatory responses (Salo, 1992). Interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α) and IL-6 have local and systemic effects that may limit injury and the spread of infection and provide a suitable environment for tissue healing and repair (Sheeran and Hall, 1997).…”

Is Neuraxial Anesthesia Safe in Patients Undergoing Surgery for Treatment of Periprosthetic Joint Infection?

“…Neuraxial anesthesia may decrease the risk of a surgical site infection via transfusion, which has been shown to be a risk factor for surgical site infections [24]. However, the lower risk of systemic infections after using neuraxial anesthesia cannot be fully explained by reduction in transfusions and might be related to changes in immune system response after general and neuraxial anesthesia [5,25,26]. Volk et al [26] suggested that neuraxial anesthesia preserves lymphocyte functions, which may contribute to ''infectious resistance'' after neuraxial anesthesia.…”