Immune Responses to General Anaesthesia with Endotracheal Intubation and Spinal Anaesthesia in Patients Undergoing Elective Surgery in Korle-Bu Teaching Hospital ACCRA, Ghana: A Baseline Study

Surgical operations and anaesthesia have been shown to cause a variety of immunological disturbances in patients. The implications of these observations are that host defenses may be compromised by surgical and anaesthesia procedures. Study participants of American Society of Anaesthiologists (ASA) physical status I or II undergoing surgery under general anaesthesia with endotracheal intubation (mastectomy, thyroidectomy) and spinal anaesthesia (herniorrhaphy) were recruited for the study. Blood samples were collected pre-operatively within 24 hrs before anaesthesia, after anaesthesia induction before incision and postoperatively at 24 hrs, and 48 hrs, from each of the study participant. Full blood count was done using automated full blood count machine and Fluorescence Activated Cell Sorting machine was used to analyse the CD3+ CD4+ and CD3+ CD8+ cells. The result of the study indicates suppression of the cellular immune responses up to 48 hours after surgery. Decreased in the cell mediated immune responses was found to be significant (P = 0.004) in general anaesthesia group as compared to the spinal anaesthesia group at 48 hours after surgery. The magnitude and duration of the reduction in cell numbers and the subpopulation affected was related to the degree of surgical trauma, stress, pain and the anesthetic agents used. Anaesthesia and surgery therefore suppresses the cellular immune responses up to 48 hours after surgery.