Immunological effects of post-operative epidural analgesia versus oral opioids in VATS.

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Danish medical journal Pub Date : 2024-09-09 DOI:10.61409/A09230582

Jimmi Højberg Holm, Claus Andersen, Peter B Licht, Palle Toft, Floor D Zegers, Kate L Lambertsen, Anne C Brøchner

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引用次数: 0

Abstract

Introduction: Anaesthetic choices in cancer surgery, including the use of epidural analgesia, may affect immune function during the perioperative period and might play an important role in subsequent cancer spread and recurrence.

Methods: This was a prospective, randomised, controlled, double-blinded, single-centre study allocating patients scheduled for video-assisted thoracoscopic surgery (VATS) lobectomy to post-operative pain management using either thoracic epidural analgesia or oral morphine. We compared pre-, per-, and post-operative plasma levels of interleukin (IL)-6, IL-10, IL-12, and interferon (IFN)-γ using regression analysis, and conducted a two-year survival follow-up.

Results: A total of 66 patients were randomised. Fifty-six received the allocated treatment and were analysed. None of the investigated cytokines exhibited significant between-group differences in plasma concentrations when adjusted for the chosen covariates (p ≥ 0.204). A two-year follow-up showed no difference in survival between the two groups (p = 0.5).

Conclusion: Our study found no differences in the impact on the innate, non-specific immune system related to epidural analgesia for pain management in VATS.

Funding: The Danish Cancer Society (R150-A10139). Oberstinde Kirsten Jensa la Cours Mindelegat (JSP-25076). University of Southern Denmark, Region of Southern Denmark and Department of Anaesthesia and Intensive Care, Odense University Hospital.

Trial registration: NCT02359175 (ClinicalTrials.gov).

查看原文本刊更多论文

VATS 术后硬膜外镇痛与口服阿片类药物的免疫学效应。

导言：癌症手术中的麻醉选择，包括硬膜外镇痛的使用，可能会影响围手术期的免疫功能，并可能在随后的癌症扩散和复发中发挥重要作用：这是一项前瞻性、随机对照、双盲、单中心研究，将计划接受视频辅助胸腔镜手术（VATS）肺叶切除术的患者分配到使用胸腔硬膜外镇痛或口服吗啡进行术后镇痛的治疗方案中。我们通过回归分析比较了术前、术中和术后血浆中白细胞介素 (IL)-6、IL-10、IL-12 和干扰素 (IFN)-γ 的水平，并进行了为期两年的生存随访：共有66名患者接受了随机治疗。结果：共有 66 名患者接受了随机治疗，其中 56 人接受了分配的治疗并进行了分析。在对选定的协变量进行调整后，所研究的细胞因子在血浆浓度方面均未显示出明显的组间差异（p ≥ 0.204）。为期两年的随访显示，两组患者的存活率没有差异（p = 0.5）：我们的研究发现，VATS 硬膜外镇痛对先天性非特异性免疫系统的影响没有差异：丹麦癌症协会（R150-A10139）。Oberstinde Kirsten Jensa la Cours Mindelegat (JSP-25076)。试验注册：南丹麦大学、南丹麦大区和欧登塞大学医院麻醉和重症监护部：NCT02359175（ClinicalTrials.gov）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Danish medical journal MEDICINE, GENERAL & INTERNAL-

CiteScore

2.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： The Danish Medical Journal (DMJ) is a general medical journal. The journal publish original research in English – conducted in or in relation to the Danish health-care system. When writing for the Danish Medical Journal please remember target audience which is the general reader. This means that the research area should be relevant to many readers and the paper should be presented in a way that most readers will understand the content. DMJ will publish the following articles: • Original articles • Protocol articles from large randomized clinical trials • Systematic reviews and meta-analyses • PhD theses from Danish faculties of health sciences • DMSc theses from Danish faculties of health sciences.