Immune function after major surgical interventions: the effect of postoperative pain treatment

Journal of Pain Research
Giada AmodeoPaola Sacerdote

Abstract

Impaired immune function during the perioperative period may be associated with worse short- and long-term outcomes. Morphine is considered a major contributor to immune modulation. We performed a pilot study to investigate postoperative immune function by analyzing peripheral blood mononuclear cells' functionality and cytokine production in 16 patients undergoing major abdominal surgery. All patients were treated with intravenous (i.v.) patient-controlled analgesia with morphine and continuous wound infusion with ropivacaine+methylprednisolone for 24 hours. After 24 hours, patients were randomized into two groups, one continuing intrawound infusion and the other receiving only i.v. analgesia. We evaluated lymphoproliferation and cytokine production by peripheral blood mononuclear cells at the end of surgery and at 24 and 48 hours postoperatively. A significant reduction in TNF-α, IL-2, IFN-γ and lymphoproliferation was observed immediately after surgery, indicating impaired cell-mediated immunity. TNF-α and IFN-γ remained suppressed up to 48 hours after surgery, while a trend to normalization was observed for IL-2 and lymphoproliferation, irrespective of the treatment group. A significant inverse correlation was present betwee...Continue Reading

Citations

Jul 13, 2019·The Journal of International Medical Research·Weilian WangYa Hu
Jun 10, 2020·The Journal of Bone and Joint Surgery. American Volume·Jordan A GruskayWilliam M Ricci
Apr 3, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Robert Beaumont Wilson
Jul 23, 2020·Patient Safety in Surgery·Lakshmanan PrakashMuzaffar Mushtaq
Jul 10, 2020·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Javier de SantiagoSonsoles Alonso
Jan 11, 2020·Frontiers in Immunology·Silvia FranchiPaola Sacerdote
Oct 22, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Lucas Hoyos MejíaDavid Gómez de Antonio
Nov 22, 2020·Journal of Neuroimmune Pharmacology : the Official Journal of the Society on NeuroImmune Pharmacology·Jonathan RoydsConnail McCrory
Oct 29, 2020·Journal of Global Health·Vittoria BellatoUNKNOWN S-COVID Collaborative Group
Mar 9, 2021·World Journal of Clinical Oncology·Maitham A MoslimSanjay S Reddy
Oct 31, 2020·International Journal of Surgery·Veeru KasivisvanathanUNKNOWN UCLH study group collaborators
May 4, 2021·Seminars in Cardiothoracic and Vascular Anesthesia·Nathan ClendenenNathaen Weitzel
May 29, 2021·The International Journal of Health Planning and Management·Ramanathan KasivisvanathanShahnawaz Rasheed
Sep 7, 2021·International Journal of Clinical Practice·Betul KuruTaner Usta
Nov 21, 2020·Annals of Surgery·Jeremy Richard HuddyHenry S Tilney

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Methods Mentioned

BETA
sedation
PCA
flow cytometry

Clinical Trials Mentioned

NCT02002663

Software Mentioned

GraphPad Prism

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