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Postoperative regional
analgesia effectively preserves perforin-expressing lymphocytes in 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 helped to maintain immune system among
patients who went through total knee replacement (TKR).
Surgical stress and pain after the surgical treatment
initiate a pro-inflammatory response which leads to a decrease in 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. Therefore, Sandra Velcic Brumnjak and colleagues attempt
to preserve and regain cytotoxic potential of NK cells, NKT cells, T
lymphocytes and their sub-populations via three types of postoperative
analgesia among patients after TKR. The evaluation of which analgesic approach
is more useful to strengthen the immune system was also done.
A total of 40 patients were selected for the
analysis. These patients were randomly assigned to three groups. Group one
patients 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 reduction in severe pain was seen in group 1
and 2 as compared to group 3. also, the NKT, NK and T lymphocytes frequencies
along with their perforin expression were considerably higher in group 1 and
group 2 as compared to group 3. the group one exhibited better outcomes as compared
to other two groups, and this reflects a considerable efficacy of regional
epidural anaesthesia.
Med Sci Monit
Postoperative Regional Analgesia Is Effective in Preserving Perforin-Expressing Lymphocytes in Patients After Total Knee Replacement
Sandra Velcic Brumnjak et al.
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