The influence of spinal and epidural anesthesia on neutrophil chemotaxis in man

In this study the effects of tetracaine spinal anesthesia with (Group II) and without (Group I) epinephrine and of lidocaine lumbar epidural anesthesia with (Group IV) and without (Group III) epinephrine on polymorphonuclear (PMN) and total white blood cell (WBC) counts and PMN chemotaxis were evaluated in 28 patients before, during, and after anesthesia and operation. Preanesthetic PMN and WBC counts and PMN chemotaxis were similar in all groups. Polymorphonuclear and WBC counts were unaffected by anesthetic techniques and operation; however, significant increases in both PMN and WBC counts occurred in all 4 groups postoperatively, after anesthesia had worn off. Polymorphonuclear chemotaxis was not altered at any time in patients in Group I to III. In contrast, patients having epidural anesthesia with epinephrine experienced a significant decrease in PMN chemotaxis during anesthesia and operation which recovered to preanesthetic levels after anesthesia wore off postoperatively. The data demonstrate that spinal anesthesia with or without epinephrine and epidural anesthesia without epinephrine do not influence PMN chemotaxis but that epidural anesthesia with epinephrine significantly impairs PMN chemotactic responses. The importance of these findings on the susceptibility to infection of patients anesthetized with epidural anesthesia plus epinephrine remains to be investigated.