Abstract:Objective: To investigate the immunomodulatory effects of patient - controlled epidural anal-gesia(PCEA). Method: The study enrolled 70 elective patients with digestive system tumor who received abdominal surgery. All patients received general anesthesia combined with epidural anesthesia. Patients were randomly and evenly allocated to two groups; PCEA group undergoing PCEA, and control group undergoing conventional postoperative analgesia (e. g. , i. m. analgesic). Venous blood samples for measurement of CD3 + ,CD4+ ,CD4 + /CD8 + ,IL-2,IL-6 were drawn prior to the start and 1 day, 3 days and 7 days after operation in the morning. Results: CD3 + declined significantly(P <0. 01 ) in both groups on the first day and there was an even more significant decrease in the control group (P <0. 05). Significant declination of CD4 + was also found in two groups on the first and third postoperative day (P <0. 01 - P < 0.05) and it was the lowest on the first day. The change was more obvious in control groups. CD4+/ CD8+ lowed significantly in PCEA group(P < 0. 05 ) and most significantly in controlled group(P<0. 01 ). IL-2 decreased in both groups on the first and third postoperative day, and no significant difference had been found between two groups. IL-6 significantly increased in both groups (P <0. 01 -P<0.05) on the first and third day, with the control group changed more dramatically (P<0.01). IL-6 recovered to normal level on the seventh postoperative day. Conclusion: The immunity of postoperative patients are inhibited and PCEA can attenuate this harmful effect.
