CHARACTERISTIC OF CELLULAR AND HUMORAL IMMUNITY IN VARIOUS TYPES OF ANESTHESIA IN PATIENTS WITH DIABETIC FOOT SYNDROME

Аннотация

Objective: comparative study of the effect of general, epidural and conduction anesthesia on the state of cellular and humoral immunity in patients with diabetic foot syndrome. Methods: 48 patients with diabetic foot syndrome were examined, who made up 3 groups depending on the use of anesthesia methods: group I - 14 patients (29.2%) operated under epidural anesthesia (EA). Group II-19 (39.6%) patients who underwent anesthesia by conduction anesthesia (PA). Group III- 15 (31.2%) patients who underwent general anesthesia (OA). The number of lymphocytes with CD3, CD4, CD8, CD20 phenotype in peripheral blood was studied and the level of IgG, IgA, IgM in blood serum was determined by ELISA. Results: it was revealed that the patients who underwent OA had deeper changes in immunity than the initial data. The indicators of the patients who underwent EA are somewhat better. In patients who underwent surgery using PA, immunological parameters remained at the level of baseline data. Therefore, PA is a more gentle anesthesia with respect to its effect on the parameters of the immune system. Conclusions. From the point of view of influencing cellular and humoral immunity, the method of choice for operations on the lower extremities in patients with diabetic foot syndrome is conductive anesthesia (PA) based on stem nerve blockades.