The influence of brachiplex nerves patient-controlled analgesia to immune functions of amutated limb(finger) replantation patients
Objecive:To study the influence of brachiplex nerves patient-controlled analgesia to immune functions of amutated limb(finger) replantation patients. Methods:Twenty amutated limb(finger) replantation patients were randomly divided into PCRA and PCIA group ,and measured circulating cytokines , C-reactive protein(CRP),cortisol ,and immune cells (neutrophilic leukocyte, histoleucocyte, lymphocytes) respectively. Results: PCRA, compared with PCIA , had no influence on altered levels of circulating cytokines (IL-6,IL-8,IL-10,TNF-α,CRP and cortisol )and histoleucocyte(P0.05). In contrast, the postoperative decrease in B lymphocytes and T-helper cells was significant in the PCRA group.Nature killer cells also decreased significantly in patients receiving PCRA compared with PCIA(P0.05).Conclusion:Postoperative epidural pain therapy had no influence on histoleucocyte function but reduced natural killer cells and preserved B-cell and T-helper cell populations .Epidural analgesia thus influenced the specific rather than the innate immune system and potentially blunts the post surgical lymphocyte depression, which was relevant to infectious resistance.