Document Detail


The proposed mechanism of action during different pain management techniques on expression of cytolytic molecule perforin in patients after colorectal cancer surgery.
MedLine Citation:
PMID:  21195559     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The postoperative period is accompanied with neuroendocrine, metabolic and immune alteration which is caused by tissue damage, anesthesia, postoperative pain and psychological stress. Postoperative pain contributes to dysfunction of immune response as a result of interaction between central nervous and immune system. The postoperatively activated hypotalamo-pituitary-adrenocortical axis, sympathic and parasympathic nerve systems are important modulators of immune response. According to bidirectional communication of immune and nervous system, appropriate postoperative pain management could affect immune response in postoperative period. Although the postoperative suppression of immune response has been reported, a very little are known about the influences of different pain management techniques on cytotoxic function of immune cells in patients with colorectal cancer in early postoperative period. Perforin is a cytotoxic molecule expressed by activated lymphocytes which has a crucial role in elimination of tumor cells and virus-infected cells, mostly during the effector's phase of immune response. Immune compromise during the postoperative period could affect the healing processes, incidence of postoperative infections and rate and size of tumor metastases disseminated during operation. The pharmacological management of postoperative pain in patients with malignancies uses very different analgesic techniques whose possible influence on cytotoxic functions of immune cells are still understood poor. For decades the most common way of treating postoperative pain after colorectal cancer surgery was intravenous analgesia with opiods. In the last decade many investigations pointed out that opiods can also contribute to postoperative suppression of immune response. Epidural analgesia is a regional anesthesia technique that acts directly on the origin of pain impulses and pain relief can be achieved with small doses of opiods combined with local anesthetics. Local anesthetics potentate analgesic properties of opiods but per se are also acting as antiinflammatory drugs. Afferent neural blockade by epidural analgesia attenuates neuroendocrine stress response. We propose that epidural analgesia could be more convenient that intravenous analgesia in maintenance of immunological homeostasis that is altered by surgical stress, tumor growth and pain.
Authors:
S Golubovic; V Golubovic; V Sotosek-Tokmadzic; A Sustic; M Petkovic; D Bacic; I Mrakovcic-Sutic
Related Documents :
11221979 - Surgically treatable upper respiratory disorders.
21217889 - Single shot epidural injection for cervical and lumbosaccral radiculopathies: a prelimi...
21615349 - A meta-analysis of the efficacy of wound catheters for post-operative pain management.
631629 - Selective angiography in acute mid-gut ischaemia.
24321619 - Local injection versus surgery in carpal tunnel syndrome: neurophysiologic outcomes of ...
24431099 - Comparison of pain and surgical outcomes between neck extension vs. no neck extension i...
21808159 - Pain in critically ill patients with substance use disorder or long-term opioid use for...
20880759 - Do informal caregivers consider nonverbal behavior when they assess pain in people with...
24733799 - Doxepin rinse versus placebo in the treatment of acute oral mucositis pain in patients ...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-12-30
Journal Detail:
Title:  Medical hypotheses     Volume:  -     ISSN:  1532-2777     ISO Abbreviation:  -     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2011-1-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7505668     Medline TA:  Med Hypotheses     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2010. Published by Elsevier Ltd.
Affiliation:
Department of Anesthesiology, Reanimatology and Intensive Care, Medical Faculty, University of Rijeka, Brace Branchetta 20, Rijeka, Croatia.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Relationship between the prenatal exposure to low-level of mercury and the size of a newborn's cereb...
Next Document:  Effects of sodium lactate and acetic acid derivatives on the quality and sensory characteristics of ...