Abstract
Degranulation of polymorphonuclear (PMN) granulocytes, complement activation, and the endocrine metabolic response to hysterectomy were compared in two groups of patients receiving either general anaesthesia (GA group) or combined epidural analgesia and general anaesthesia (GAE group). The B-leucocyte and the cortisol responses were attenuated in the GAE group. There was no sign of complement activation. The post-operative rise in elastase-alpha-1-proteinase levels 4 h post-operatively on the first, second and third post-operative days was similar in the two groups. Plasma lactoferrin values were significantly elevated 4 h post-operatively and reached pre-operative values on Day 1 in both groups. Attenuation of the surgical stress response during uncomplicated hysterectomy did not influence the post-operative increase in proteinase activity. Mediators generated at the site of surgical trauma may account for the PMN degranulation observed after major surgery.
Publication types
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Clinical Trial
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Randomized Controlled Trial
MeSH terms
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Adult
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Analgesia, Epidural*
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Anesthesia, General*
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B-Lymphocytes / pathology
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Bupivacaine / administration & dosage
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Cell Degranulation / physiology*
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Complement C3d / analysis
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Endopeptidases / metabolism*
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Female
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Fentanyl / administration & dosage
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Humans
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Hydrocortisone / blood
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Hysterectomy
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Intraoperative Complications / physiopathology
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Intraoperative Complications / prevention & control*
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Lactoferrin / blood
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Leukocyte Count
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Midazolam / administration & dosage
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Middle Aged
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Neutrophils / enzymology
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Neutrophils / pathology
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Neutrophils / physiology*
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Pancreatic Elastase / blood
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Postoperative Complications / physiopathology*
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Stress, Physiological / physiopathology
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Stress, Physiological / prevention & control*
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Vecuronium Bromide / administration & dosage
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alpha 1-Antitrypsin / analysis
Substances
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alpha 1-Antitrypsin
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Vecuronium Bromide
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Complement C3d
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Endopeptidases
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Lactoferrin
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Pancreatic Elastase
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Midazolam
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Fentanyl
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Hydrocortisone
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Bupivacaine