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Effect of epidural and intravenous clonidine on the neuro-endocrine and immune stress response in patients undergoing lung surgery

Published online by Cambridge University Press:  16 August 2006

V. Novak-Jankoviĉ
Affiliation:
Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Centre, Ljubljana, Slovenia
V. Paver-Eržen
Affiliation:
Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Centre, Ljubljana, Slovenia
J. G. Bovill
Affiliation:
Institute of Microbiology and Immunology, University Medical Centre, Ljubljana, Slovenia
A. Ihan
Affiliation:
Institute of Clinical Chemistry and Clinical Biochemistry, University Medical Centre, Ljubljana, Slovenia
J. Osredkar
Affiliation:
Department of Anaesthesiology, Leiden University Medical Centre, Leiden, The Netherlands
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Abstract

The effects of intravenous and epidural clonidine, 4 μg kg−1, combined with epidural morphine, 40 μg kg−1, on the neuro-endocrine and immune stress responses to thoracic surgery are reported. A control group received only epidural morphine. Anaesthesia was induced and maintained with propofol. Catecholamines, vasopressin, cortisol, β-endorphin concentrations and leucocyte counts were measured before drug administration, immediately after intubation of the trachea, after thoracotomy and at the end of surgery. Catecholamines did not change in any of the groups. The other stress hormones increased during surgery, the pattern being similar in the three groups. Total leucocyte and neutrophil counts were increased in all groups at the end of surgery, but the increase was least in the epidural clonidine group. The number of lymphocytes was reduced at the end of surgery in the epidural and intravenous group, compared with the control group in which the number of lymphocytes did not change. The effects are more pronounced with epidural than with intravenous administration. We conclude that clonidine can modulate the immune stress response to thoracic surgery.

Type
Original Article
Copyright
2000 European Society of Anaesthesiology

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