EPIDURAL-ANESTHESIA BLOCKS CHANGES IN PERIPHERAL LYMPHOCYTES SUBPOPULATION DURING GASTRECTOMY FOR STOMACH-CANCER

To examine the effects of surgery and anaesthesia on cell-mediated and humoral immunity, we investigated changes in subpopulations of periph eral T cells and B cells during gastrectomy. Twenty-one patients with gastric cancers who underwent total or subtotal gastrectomy were rando mly assigned to receive thiopental/N2O general anaesthesia supplemente d with either epidural;epidural group, n=12) or enflurane(enflurane gr oup, n=9). The changes in peripheral lymphocyte subpopulations were de tected and quantified using single and double label analysis of monocl onal antibodies against lymphocyte membrane surface markers (Leu serie s). Subpopulations were measured before induction, and 1 and 2 hours a fter skin incision. In the enflurane group, B cells (Leu12(+)), total T cells (Leu4(+)), inducer T cells (CD4(+)), Leu8(+)) and the CD4/CD8 ratio decreased and suppressor T cells (CD8(+), Leu15(+)) increased si gnificantly after skin incision. Whereas, the epidural group showed no change in the number of B cells and each T cell subpopulation during the study. These data suggest that epidural anaesthesia blocks the eff ect of siress induced by major surgery on fluctuation of peripheral ly mphocyte subpopulations which may be associated with suppression of im munity.