The Effect of Anesthetic Technique on White Blood Cell Response to Surgery in Patients Who Underwent Laparoscopic Cholecystectomy and Cesarian Section.

Kim,  Myung Hee; Kang,  Yoon Jeong

doi:2000.39.3.374

Clinical Research Article

Korean Journal of Anesthesiology 2000;39(3):374-379.
DOI: https://doi.org/10.4097/kjae.2000.39.3.374

The Effect of Anesthetic Technique on White Blood Cell Response to Surgery in Patients Who Underwent Laparoscopic Cholecystectomy and Cesarian Section.

Myung Hee Kim, Yoon Jeong Kang

Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND
Surgical stress causes changes in the composition of white blood cells in peripheral blood. In addition, anesthesia itself has been suggested to have an immunosuppressive effect. Therefore, the aim of the present study was to investigate the effect of anesthetic technique on the changes of postoperative peripheral white blood cell (WBC) subsets in laparoscopic cholecystectomy patients and cesarian section patients.
METHODS
We reviewed 100 patients who had laparoscopic cholecystectomy under conventional general anesthesia or propofol infusion. Each group contained 50 patients equally. We also reviewed 100 patients who had cesarian section under spinal and epidural anesthesia, 50 patients in each group, respectively. The changes of total WBC, lymphocytes, neutrophils and monocytes at 24 h and 48 h postoperatively were compared to baseline values within the groups and these values were compared between the groups.
RESULTS
There were significant increases in total WBC and neutrophils, decreases in lymphocytes, no changes in monocytes at 24 h after surgery compared to baseline values for the groups receiving laparoscopic cholecystectomy. No differences were found between the two laparoscopic cholecystectomy groups. Cesarian section patients showed significant differences in total WBC, neutrophils, lymphocytes and monocytes at 48 h after surgery compared to baseline values for the groups. There were no significant differences between the groups.
CONCLUSIONS
Neither laparoscopic cholecystectomy nor cesarian section showed significant differences in WBC subsets after surgery according to anesthetic technique.

Key Words: Anesthetics: enflurane; propofol; Anesthetic technique: epidural anesthesia; spinal anesthesia; Surgery: laparoscopic cholecytectomy; cesarian section; White Blood Cells: monocytes, neutrophils, lymphocytes