[Mechanisms of the effect of general anesthesia with barbiturates on immunity]. / Mekhanizmy vliianiia obshchei anestezii barbituratami na immunitet.

The effect of short-acting barbiturates on the number of theophylline-resistant and theophylline-sensitive T-lymphocytes in donors and patients with lung cancer on the function of spontaneous and induced donor regulators as well as the concentration of cyclic nucleotides and T-lymphocytes in donors has been studied in vitro. The effect of general anesthesia with barbiturates on the number of lymphocyte populations and subpopulations in the peripheral blood of somatically healthy patients with minimum surgical trauma has also been assessed. These studies as well as previous investigations serve the basis for elucidating the impact of general anesthesia with barbiturates on the immunity. It is recommended to identify the nature of immunodepression in patients with preoperative immune deficiencies.

[A method of modified neuroleptanalgesia in lung surgery]. / Metod modifitsirovannoi neiroleptanalgezii v khirurgii legkikh.

A modification of neuroleptanalgesia (NLA) has been developed to be applied in operations on the lungs. It is based on the inclusion of indomethacin and diazepam into premedication, on the bolus administration of phentanyl, droperidol, and diazepam prior to the most traumatic stages of the operation, and on the subsequent infusion of phentanyl and droperidol. The modified technique of NLA has been applied in operations on 19 patients with lung cancer. The control (traditional NLA technique) consisted of 20 lung cancer patients. Evaluation of the endocrine response and venous blood plasma concentration of metabolites of polyunsaturated fatty acids showed a possibility for reducing the stress response to the operative trauma by using the modified NLA technique. The advantages of this method are well demonstrated in the course of the postoperative period as a lowered incidence of postoperative inflammatory complications.

[Neuroleptanalgesia, surgical trauma and immunity]. / Neiroleptanalgeziia, operatsionnaia travma i immunitet.

Immune status and hormonal homeostasis have been studied in 26 patients with larynx cancer operated on (laryngectomy, extended laryngectomy) under neuroleptanalgesia. It has been established that 3 and 7 days after the operation there was a decrease in plasma cortisol level and an increase in B- and T-lymphocyte count and theophylline-resistant T-lymphocyte count in the peripheral blood. In 4 patients with postoperative complications (pharyngeal fistulas) there was a reverse correlation between cortisol content and B-lymphocyte count and T-lymphocyte blast transformation.

[Droperidol, seduxen, fentanyl: a study of immune reactions in vitro]. / Droperidol, seduksen, fentanil: izuchenie reaktsii immuniteta in vitro.

Clinical concentration of droperidol, seduxen, fentanyl were studied for their effects on in vitro immunity reaction with lymphocytes from donors and patients with lung carcinoma. In the donors, the agents caused no changes in E- and EAC-rosette formation. In the patients with lung carcinoma, droperidol elevated the number of theophylline-sensitive T lymphocytes, lowered theophylline-resistant ones and eventually normalized a theophylline-resistant to theophylline-sensitive T cell ratio. Fentanyl, 5 ng/ml was demonstrated to increase amounts of early T lymphocytes. Fentanyl concentrations (5 and 25 ng/ml) decreased B lymphocytes. It was concluded that droperidol produced a positive action and fentanyl showed heterogeneous effects on E- and EAC-rosette formation in patients with lung carcinoma.

[Role of anesthesia in the development of postoperative infectious complications in thoracic oncological surgery]. / Rol' anestezii v razvitii posleoperatsionnykh infektsionnykh oslozhnenii v grudnoi onkokhirurgii.

Clinical analysis of incidence and degree of postoperative infectious complications was made in 140 patients subjected to operations on the lungs for cancer. The analysis has shown that in the group of patients operated upon under conditions of combined halothane anesthesia, the incidence and degree of postoperative infectious complications (suppuration of wounds, pneumonia in the other lung, empyema of the pleura) were considerably higher than in the group of patients operated on under conditions of neuroleptoanesthesia. The incidence of infectious complications was also higher in patients operated upon after preoperative irradiation. Mechanisms of immunosuppressive effects of general halothane anesthesia are discussed.