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.