Addition of noradrenaline to intrathecal morphine augments the postoperative suppression of natural killer cell activity

被引:5
作者
Yokota T. [1 ]
Uehara K. [1 ]
Nomoto Y. [1 ]
机构
[1] Department of Anaesthesiology, Kanto Rohsai Hospital, Nakahara-ku, Kawasaki 211-8510
关键词
Morphine; NK cell activity; Noradrenaline; Spinal anesthesia;
D O I
10.1007/s00540-004-0247-3
中图分类号
学科分类号
摘要
Purpose. Intrathecal administration of morphine has been shown to suppress natural killer (NK) cell activity. We tested the hypothesis that combined administration of morphine and noradrenaline would further modify NK cell activity in patients undergoing hysterectomy. Methods. Thirty female patients were randomly divided into three groups of ten patients each. Groups MN and M received intrathecal morphine (0.5 mg) dissolved in 5 ml of physiological saline with and without 5 μg noradrenaline, respectively. Group C received saline alone. After the intrathecal administration, general anesthesia was induced. Blood samples were withdrawn before and 2 h after surgery and on postoperative days 1, 2, and 7 to determine the NK cell activity, the ratio of T-helper/inducer cells (CD4) to T-suppressor/cytotoxic cells (CD8), the levels of interleukin-6 (IL-6) and interleukin-8 (IL-8), and the plasma concentrations of catecholamines and cortisol. Results. NK cell activity decreased on postoperative day 1 in groups MN (12.0 ± 2.7%) and M (25.4 ± 9.6%) compared with their respective baseline levels. In group MN, NK cell activity remained lower (23.7 ± 8.0%) on postoperative day 2 than the baseline value before surgery. Conclusion. Intrathecal administration of morphine causes a decrease in NK cell activity, and its combined use with noradrenaline prolongs the suppression of NK cell activity. © JSA 2004.
引用
收藏
页码:190 / 195
页数:5
相关论文
共 26 条
  • [1] Yokota T., Uehara K., Nomoto Y., Intrathecal morphine suppresses NK cell activity following abdominal surgery, Can. J. Anaesth., 47, pp. 303-308, (2000)
  • [2] Goyagi T., Nishikawa T., The addition of epinephrine enhances postoperative analgesia by intrathecal morphine, Anesth. Analg., 81, pp. 508-513, (1995)
  • [3] Goto F., Fujita N., Fujita T., Cerebrospinal fluid catecholamine levels and duration of spinal anaesthesia, Can. J. Anaesth., 35, pp. 157-161, (1988)
  • [4] Pollock R.E., Lotzova E., Stanford S.D., Mechanism of surgical stress impairment of human perioperative natural killer cell cytotoxicity, Arch. Surg., 126, pp. 338-342, (1991)
  • [5] Pollock R.E., Lotzova E., Stanford S.D., Surgical stress impairs natural killer cell programming of tumor lysis in patients with sarcomas and other solid tumors, Cancer, 70, pp. 2192-2202, (1992)
  • [6] Colaccio T.A., Yeager N.P., Hildebrandt L.W., Perioperative immunomodulation in cancer surgery, Am. J. Surg., 167, pp. 174-179, (1994)
  • [7] Salo M., Effects of anaesthesia and surgery on the immune response, Acta Anaesthesiol. Scand., 36, pp. 201-220, (1992)
  • [8] Peterson P.K., Molitor T.W., Chao C.C., Mechanisms of morphine induced immunomodulation, Biochem. Pharmacol., 46, pp. 343-348, (1993)
  • [9] Arora P.K., Fride E., Petitto J., Waggie K., Skolnick P., Morphine induced immune alterations in vivo, Cell Immunol., 126, pp. 343-353, (1990)
  • [10] Yeager M.P., Yu C.T., Campbell A.S., Effect of morphine and β-endorphine on human Fc receptor-dependent and natural killer cell functions, Clin. Immunol. Immunopathol., 62, pp. 336-343, (1992)