THE IMPACT OF REGIONAL ANESTHESIA ON INFLAMМATORY AND STRESS RESPONSE TO SURGERY

Abstract

The operative trauma triggers an inflammatory response that leads to a series of cascade changes known as the stress response to surgery. During extensive surgical procedures, the development of excessive stress response can result in transient suppression of the immune system. Natural killer cells (NK cells) and Cytotoxic T lymphocytes (CTLs) are the basis of the innate immunity, which is considered the primary defense against the dissemination of malignant cells and infection. One very significant discovery in anesthesiology was that anesthetic treatment can limit the excessive stress response after surgery. It is confirmed that both intravenous lidocaine as a part of a combined anesthesia protocol and regional anesthesia (RA), have positive effects in the reduction of proliferation and migration of malignant cells, as well as in the prevention of excessive and potentially harmful inflammatory reaction and preservation of the innate immunity. Regional anesthesia techniques have already surpassed their primary role in performing operative analgesia. Rather, they are a valuable addition to anesthetic strategy in the prevention of excessive and potentially harmful inflammatory reaction and preservation of the innate immunity.

Aim: we conducted a literature search to identify the most recent available data on the inflammatory and stress responses associated with the use of regional anesthetic techniques. In addition, we also provide our practical experience with these two techniques.