Effect of anaesthesia and surgery on the number of and mitogen-induced transformation of T- and B-lymphocytes.

Lymphocyte responses are affected by anaesthesia and surgery. 52 patients were studied to ascertain the affect on lymphocytic responses of thiopentone +N2O +O2, combined, diethyl ether +N2O +O2, and local anaesthesia in connection with surgery. The variables followed were: the leucocyte and differential count, the T- and B-lymphocyte count, and lymphocyte transformation by phytohaemagglutinin (PHA), concanavalin A (Con A), pokeweed mitogen (PWM), and purified protein derivative of tuberculin (PPD) in cultures using separated lymphocytes and whole blood. Thiopentone +N2O +O2 anaesthesia together with uterine curettage caused a decrease in the total lymphocyte and T-lymphocyte counts. The Con A response of separated lymphocytes decreased, but the response to other mitogens increased. Combined anaesthesia with thiopentone +N2O +O2 + analgesic + muscle relaxant together with surgery decreased the total lymphocyte and T-lymphocyte counts. The separated lymphocytic and whole blood cultures revealed throughout a decrease in the mitogen and PPD responses. Diethyl ether +N2O +O2 and local anaesthesia, both together with surgery, produced no statistically significant changes in the total lymphocyte or in the T- and B-lymphocyte counts. The mitogen and PPD responses in these groups showed throughout a fall in lymphocyte transformation. Neither patient's age, sex, nor the duration of the anaesthesia or operation affected the magnitude of the changes. The increase in the leucocyte count and in the percentage of neutrophils and the decrease in the percentage of eosinophils and lymphocytes and in the mitogen- and PPD-induced lymphocytic responses increased with the severity of the operative trauma. A new finding was the correlation observed between the changes in the leucocyte and differential counts and the decrease of lymphocytic responses in whole blood culture. The findings in this study indicate that operative trauma determine the decrease in lymphocytic responses associated with anaesthesia and surgery.