title: Local and systemic immune response to surgery under balanced anaesthesia in children.
abstract: We studied perioperative changes in the immune response and compared changes in the peripheral blood with those in the wound in 20 boys (0.5-3 years) during elective inguinal surgery under balanced anaesthesia. Blood samples were drawn before premedication, immediately, and 4 or 24 h after anaesthesia. Cells from the wound were harvested with the Cellstick device, removed from the wound 4 (n=10) or 24 h (n=10) after anaesthesia. We found decreased lymphocyte counts in the peripheral blood, increased percentages of activated T lymphocytes and B lymphocytes, and decreased percentages of total T lymphocytes, T helper cells and T cytotoxic cells. The percentages of T helper cells and B lymphocytes were lower in the wound than in blood. Mitogen-induced lymphocyte proliferative responses decreased. This study demonstrates perioperative changes in the immune response in children and, as a new finding, that immune effector cells in the blood and in the wound are in a dynamic balance.
authors.affiliation: Department of Anaesthesiology and Medicity Research Laboratory, Turku University Central Hospital, FIN-20520 Turku, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Mattila-Vuori
authors.forename: M
authors.initials: M
authors.lastname: Salo
authors.forename: E
authors.initials: E
authors.lastname: Iisalo
authors.forename: O
authors.initials: O
authors.lastname: Pajulo
authors.forename: J
authors.initials: J
authors.lastname: Viljanto
mesh_terms: D000704:Analysis of Variance; D000768:Anesthesia, General; D001402:B-Lymphocytes / Q000473:pathology; D001769:Blood; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery; D005500:Follow-Up Studies; D005832:Genital Diseases, Male / Q000473:pathology / Q000601:surgery*; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007111:Immunity, Cellular / Q000276:immunology*; D007223:Infant; D016014:Linear Models; D008213:Lymphocyte Activation / Q000187:drug effects; D018655:Lymphocyte Count; D008297:Male; D008934:Mitogens / Q000494:pharmacology; D011229:Preanesthetic Medication; D013601:T-Lymphocytes / Q000473:pathology; D013602:T-Lymphocytes, Cytotoxic / Q000473:pathology; D006377:T-Lymphocytes, Helper-Inducer / Q000473:pathology; D006848:Testicular Hydrocele / Q000601:surgery
chemical_list: D008934:Mitogens; D006854:Hydrocortisone