BACKGROUND: The intraoperative epidural @entity1337 (EA) has the potential to reduce stress response to surgical @entity130 which induces a transient immunoactivation that has a negative impact on the outcome. This study investigates the effect of intraoperative EA versus intravenous @entity1337 (IA) on the immune function. METHODS: A total of 35 consecutive @entity1 candidated to undergo major surgery for @entity694 were randomly assigned to intraoperative EA (n = 18) or IA (n = 17). Blood samples for @entity310 , @entity379 , @entity1192 , @entity1199 , @entity3646 , @entity650 , @entity688 , IL-12, and @entity2841 were obtained before surgery (T(pre)), 3 h (T(3h)), and 24 h (T(24h)) after skin incision. Data on @entity260 were prospectively collected and analyzed. RESULTS: In the EA group, @entity3646 increased from T(pre) to T(3h) and from T(3h) to T(24h), @entity688 increased from T(pre) to T(3h) and persisted unmodified thereafter. At all time-points, @entity3646 and @entity688 serum levels were significantly higher than those in the IA group. Conversely, in the IA group, @entity3646 and @entity688 serum levels did not change while all other cytokines levels were significantly higher compared with the EA group. In particular, @entity650 progressively reached a 7-fold increase of its basal value at T(24h). Complications were significantly more common in IA @entity1 (13 of 17) compared with EA @entity1 (7 of 18) (P = .024). CONCLUSIONS: Our results indicate that in @entity5 @entity1 undergoing major elective colon surgery, the EA attenuates the surgery-induced proinflammatory response and the typical postoperative transient immunosuppression and seems associated with a reduced rate of @entity260 compared with IA.

Intraoperative epidural @entity1337 prevents the early proinflammatory response to surgical @entity130 . Results from a prospective randomized clinical trial of intraoperative epidural versus general XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity650 :: ('3569', 'Gene') :: ['IL-6'] @entity310 :: ('7124', 'Gene') :: ['TNF-a'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity1337 :: ('MESH:D000699', 'Disease') :: ['analgesia'] @entity260 :: ('MESH:D011183', 'Disease') :: ['postoperative complications'] @entity688 :: ('3586', 'Gene') :: ['IL-10'] @entity379 :: ('3458', 'Gene') :: ['IFN-y'] @entity1192 :: ('3552', 'Gene') :: ['IL-1'] @entity1199 :: ('3558', 'Gene') :: ['IL-2'] @entity3646 :: ('3565', 'Gene') :: ['IL-4'] @entity694 :: ('MESH:D003110', 'Disease') :: ['colon cancer'] @entity2841 :: ('1437', 'Gene') :: ['GM-CSF'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity1337 :: (MESH:D000699,Disease) :: ['analgesia']
