The effects of epidural anaesthesia and analgesia on natural killer cell cytotoxicity and cytokine response in patients with epithelial ovarian cancer undergoing radical resection

J Int Med Res. 2012;40(5):1822-9. doi: 10.1177/030006051204000520.


Objective: Epidural anaesthesia appears to promote antitumourigenic activity in patients with malignant disease who are undergoing surgery. This study investigated immune function in women with epithelial ovarian cancer undergoing radical resection with either general anaesthesia alone or in combination with epidural anaesthesia.

Methods: Patients (n = 61) were randomized to receive either combined general/epidural anaesthesia (study group) or general anaesthesia alone (control group). Natural killer cell cytotoxicity (NKCC) and serum concentrations of four cytokines (interleukin [IL]-1β, -8 and -10 and interferon [IFN]-γ) were measured before anaesthesia (T(pre)) and 4 h after skin incision (T(4 h)) in both groups.

Results: In both groups, concentrations of protumourigenic cytokines (IL-1β and IL-8) were significantly higher at T(4 h) than at T(pre), while concentrations of antitumourigenic cytokines (IL-10 and IFN-γ) and NKCC were significantly lower at T(4 h). The study group had significantly higher NKCC, IL-10 and IFN-γ levels and lower IL-1β and IL-8 levels at T(4 h) compared with the control group.

Conclusion: Combined general/epidural anaesthesia appeared to promote antitumourigenic NKCC and cytokine responses.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Analgesia, Epidural*
  • Anesthesia, Epidural*
  • Anesthesia, General
  • Carcinoma, Ovarian Epithelial
  • Cytokines / blood
  • Cytotoxicity, Immunologic*
  • Female
  • Humans
  • Hysterectomy
  • Killer Cells, Natural / immunology*
  • Middle Aged
  • Neoplasms, Glandular and Epithelial / blood
  • Neoplasms, Glandular and Epithelial / immunology*
  • Neoplasms, Glandular and Epithelial / surgery
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / immunology*
  • Ovarian Neoplasms / surgery
  • Pain Management


  • Cytokines