Local and systemic immune response to surgery under balanced anaesthesia in children

We studied perioperative changes in the immune response and compared change s 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 anaesthes ia. 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 decrease d lymphocyte counts in the peripheral blood, increased percentages of activ ated T lymphocytes and B lymphocytes, and decreased percentages of total T lymphocytes, T helper cells and T cytotoxic cells. The percentages of T hel per cells and B lymphocytes were lower in the wound than in blood. Mitogen- induced lymphocyte proliferative responses decreased. This study demonstrat es perioperative changes in the immune response in children and, as a new f inding, that immune effector cells in the blood and in the wound are in a d ynamic balance.