Regional Anesthesia and Acute Pain ManagementRegional Anesthesia and Acute Pain ManagementРегионарная анестезия и лечение острой боли1993-65082687-1394Eco-Vector6238710.17816/RA62387Original study articlesОригинальные исследованияResearch ArticleInfluence of anesthesia methods on the immune system of patients with oncological diseases of the abdominal organsВлияние методов анестезии на иммунную систему у больных с онкологическими заболеваниями органов брюшной полостиhttps://orcid.org/0000-0001-9135-6392NeimarkM. I.НеймаркМ. И.
Russian Federation
sayat68@mail.ruhttps://orcid.org/0000-0001-8958-8768TanatarovSayat Z.ТанатаровСаят Замамбекович
Kazakhstan

MD, PhD, DSc, Assistant of the Department of Anesthesiology and Reanimatology, NJSC “Semey Medical University”

д.м.н., ассистент кафедры анестезиологии и реаниматологии НАО «Медицинский университет Семей»

sayat68@mail.ruAltai State Medical University of the Ministry of Health of the Russian FederationФГБУ ВО «Алтайский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииNon-profit Joint Stock Company “Semey Medical University”Некоммерческое акционерное общество (НАО) «Медицинский университет Семей»081220201441851920103202101032021Copyright ©; 2020, Eco-VectorCopyright ©; 2020, ООО "Эко-Вектор"2020Eco-VectorООО "Эко-Вектор"https://rjraap.com/1993-6508/article/view/62387

Modern anesthesia, based on the use of halogenated hydrocarbons, nitrogen monoxide, or xenon, cannot fully ensure the interruption of nociceptive impulses at the level of the stem and spinal and subcortical formations, which caused vegetative and metabolic signs related to pain. To prevent the negative effects of pain, additional methods are used, including intraoperative analgesia and regional blockades. This study was conducted to assess the effects of various types of anesthesia, including epidural blockade, on the parameters of the immune system in patients with cancer. A total of 438 patients with malignant neoplasms of the abdominal organs were examined. In these patients, levels of cytokines (such as tumor necrosis-alpha and interleukin-6) and T-lymphocytes of various clusters of differentiation in the blood were measured. Impaired cytokine balance in patients with oncological diseases of the abdominal cavity was accompanied by the formation of suppression of cellular immunity in the postoperative period. Measurements revealed immunosuppression that was largely dependent on the type of anesthesia used. Cellular parameters with the greatest relationship with immunity were preserved during combined anesthesia, including epidural blockade.

Современная анестезия, основанная на применении галогенсодержащих углеводородов, монооксида азота или ксенона, не может в полной мере обеспечить прерывание ноцицептивной импульсации на уровне стволовых, спинномозговых и подкорковых образований, осуществляющих вегетативную и метаболическую реализацию болевого воздействия. С целью предотвращения негативных влияний болевого воздействия применяются дополнительные методы, в том числе интраоперационная анальгезия и региональные блокады.

Исследование проведено в отношении влияния различных видов анестезии, включающих эпидуральную блокаду, на показатели иммунной системы у онкологических больных. Обследовано 438 пациентов со злокачественными новообразованиями органов брюшной полости. Определяли содержание цитокинов (ФНО-альфа и интерлейкин-6) и содержание Т-лимфоцитов различных кластеров дифференцировки в крови.

Нарушения цитокинового баланса сопровождалось у больных с онкологическими заболеваниями органов брюшной полости формированием в послеоперационном периоде угнетения клеточного иммунитета. Выявленная иммуносупрессия в значительной степени зависела от применëнного метода анестезии. Наиболее высокие параметры клеточного звена иммунитета сохранились при проведении сочетанной анестезии, включающей эпидуральную блокаду.

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