LETTER
RANDOMIZED CONTROLLED TRIAL
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Effects of two different anesthetic methods on cellular immunity of patients after liver cancer resection.

This study aims to investigate the effects of epidural block in combination with general anesthesia and general anesthesia alone on the immune function of patients undergoing primary liver cancer resection. Twenty-four patients with liver cancer who received treatment in the Third Hospital of Harbin Medical University, Heilongjiang, China, were enrolled and randomly allocated into group A and group B, with 12 in each group. The data on the T lymphocyte subpopulation, pro-inflammatory cytokines and antiinflammatory cytokines were recorded before, immediately after and 24 h after liver cancer resection to compare differences and changes. It was found that CD4+ of patients who underwent combined anesthesia decreased after surgery and CD8+ of those patients was lower than that of the general anesthesia group. The content of interleukin (IL)-10 of patients who underwent general anesthesia combined with epidural block showed a decreasing tendency immediately after surgery, but increased 24 h after surgery, and the increase was greater than that of the general anesthesia group; furthermore, those patients had lower levels of IL-1β and interferon (IFN)-γ. In addition, patients who underwent epidural block and general anesthesia had a higher ratio of IFN-γ to IL-4 (Th1/Th2). These findings suggest that general anesthesia combined with epidural block has little passive influence on the cellular immunity of the body and can be selected as an anesthetic approach for patients with liver cancer.

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