title: The effects of epidural anaesthesia and analgesia on natural killer cell cytotoxicity and cytokine response in patients with epithelial ovarian cancer undergoing radical resection.
abstract: OBJECTIVE
  Epidural anaesthesia appears to promote antitumourigenic activity in patients with malignant disease who are undergoing surgery. This study investigated immune function in women with epithelial ovarian cancer undergoing radical resection with either general anaesthesia alone  or in combination with epidural anaesthesia.
  
  
  METHODS
  Patients (n = 61) were randomized to receive either combined general/epidural anaesthesia (study group) or general anaesthesia alone (control group). Natural killer cell cytotoxicity (NKCC) and serum concentrations of four cytokines  (interleukin [IL]-1β, -8 and -10 and interferon [IFN]-γ) were measured before anaesthesia (T(pre)) and 4 h after skin incision (T(4 h)) in both groups.
  
  
  RESULTS
  In both groups, concentrations of protumourigenic cytokines (IL-1β and IL-8) were  significantly higher at T(4 h) than at T(pre), while concentrations of antitumourigenic cytokines (IL-10 and IFN-γ) and NKCC were significantly lower at T(4 h). The study group had significantly higher NKCC, IL-10 and IFN-γ levels  and lower IL-1β and IL-8 levels at T(4 h) compared with the control group.
  
  
  CONCLUSIONS
  Combined general/epidural anaesthesia appeared to promote antitumourigenic NKCC and cytokine responses.
authors.affiliation: Department of Anaesthesiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: H
authors.initials: H
authors.lastname: Dong
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: H
authors.initials: H
authors.lastname: Xi
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000077216:Carcinoma, Ovarian Epithelial; D016207:Cytokines / Q000097:blood; D003602:Cytotoxicity, Immunologic; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007694:Killer Cells, Natural / Q000276:immunology*; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood / Q000276:immunology* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000097:blood / Q000276:immunology* / Q000601:surgery; D059408:Pain Management
chemical_list: D016207:Cytokines