Influence of neural blockade and indomethacin on leucocyte, temperature, and acute-phase protein response to surgery

Body temperature, P-cortisol, P-glucose, P-transferrin, haematocrit and total and differential leucocyte counts were investigated in 24 men undergoing inguinal herniotomy, but otherwise healthy. The patients were randomized to general anaesthesia (GA, n = 8), epidural analgesia (E, n = 8) or epidural analgesia + indomethacin (E + I, n = 8). The rectal temperature rose significantly after surgery, except in the E + I group, and increase in blood granulocytes was significantly less in these patients than in the GA group. Group E showed intermediate changes. P-transferrin changes were similar in all three groups. Glucose and cortisol showed only slight increase in the GA group and constant values in groups E and E + I. It is concluded that prostaglandins may play a role in mediating the surgical stress response, but that factors other than neural stimuli and prostaglandins are important in releasing postoperative granulocytosis.