Effects of Anesthetic Technique on NK Cells

Launched by CEDARS-SINAI MEDICAL CENTER · Jan 27, 2016

Keywords

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Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 18 - 80 years old of either gender
• • Diagnosis of abdominal tumor scheduled for exploratory laparotomy with study surgeon
• • Must be able to have an epidural
• Exclusion Criteria:
• • ASA IV and above
• • Intolerance, allergy, or contraindication to use of either fentanyl or bupivacaine.
• • Significant coronary artery disease (abnormal stress test, myocardial infarction within the last 3 months)
• • Uncontrolled hypertension (BP \> 140/90)
• • Cardiac arrhythmias particularly prolonged QT syndrome
• • Drugs known to cause prolonged qT: class IA antiarrhythmics (quinidine, procainamide, dysopyramide), class III antiarrhythmics (sotalol, dofetalide, ibutalide, amiodarone), haloperidol, thioridazine, arsenic trioxide, HIV protease inhibitors, tricyclic antidepressants
• • Individuals with significant psychological disorders including: schizophrenia, mania, bipolar disorder or psychosis
• • Pregnant or lactating women
• • Morbid obesity (BMI \> 40 kg/m2) AND/OR weight \> 150 kg
• • Chronic renal failure ( creatinine \> 2.0 mg/dL)
• • Liver failure e.g., active cirrhosis
• • Alcohol or substance abuse within in the past 3 months
• • Uncorrected hypokalemia, hypomagnesemia, hypocalcemia (can be due to diuretics, mineralocorticoid use, laxatives)
• • Neuropathic pain
• • Chronic opioid consumption (\>30mg oxycodone or greater per day)
• • Cachexia from any cause
• • Systemic use of corticosteroids for greater than 2 weeks in the 6 months prior to surgery
• • HIV or other immunosuppressive condition
• • Preoperative INR \> 1.4 or platelet count \< 100
• • Sepsis or overlying skin cellulitis at epidural catheter insertion site
• • Inability to tolerate/unwillingness to have an epidural catheter for intraoperative/postoperative pain control for any reason, including prior back surgery resulting in distorted anatomy that precludes neuraxial anesthesia.
• • Inability to tolerate an epidural solution of either fentanyl or bupivacaine or needs another form of specialized pain control.