Effects of general anesthesia combined with epidural block on stress response and shift of T helper cells in patients after cervical cancer surgery

Abstract Objective To evaluate the effects of general anesthesia combined with epidural block on the stress response and shift of T helper (Th) cells in patients after cervical cancer surgery. Methods A total of 106 patients undergoing radical surgery of cervical cancer were randomly assigned into a general anesthesia combined with epidural block (observation) group and a general anesthesia (control) group. Peripheral blood was collected before anesthesia (T0), during anesthesia maintenance (T1), as well as 10 min (T2), 1 d (T3), 2 d (T4) and 7 d after surgery (T5). The levels of cytokines interferon-γ (IFN-γ), interleukin-4 (IL-4) and transforming growth factor-β1 (TGF-β1) were detected by ELISA, and IFN-γ/IL-4 ratio was calculated. Results Compared with the control group, the observation group had significantly lower levels of GH, PRL and Cor, proportions of Th2 and Treg cells, and levels of IL-4 and TGF-β1 during anesthesia maintenance and at each time point after surgery (P < 0.05), but higher proportion of Th1 cells, Th1/Th2 cell ratio, IFN-γ level and IFN-γ/IL-4 ratio (P < 0.05). Conclusion General anesthesia combined with epidural block can better alleviate the stress response and protect the immune function of patients after cervical cancer surgery.