Immunomodulatory Effects of Epidural Anesthesia in Patients Undergoing Breast Cancer Surgery

BACKGROUND: The immune system is suppressed in cancer patients. Identifying the anesthetic procedures that trigger immunomodulation is essential to slow the growth of tumors. Our study's objective was to evaluate how epidural anesthesia affected immunomodulators in individuals having breast cancer surgery. METHODS: Thirty patients undergoing thoracic epidural anesthesia for breast cancer surgery participated in this prospective observational study. Immunomodulator blood samples were taken both before and 2 h after anesthesia. RESULTS: On comparing interleukin (IL)-1 count before and after epidural anesthesia, there was a statistically significant decrease. On comparing the IL-2, IL-10, and tumor necrosis factor (TNF) before and after epidural anesthesia, there was no change. IL-6 count levels dropped, which was not statistically significant. On comparing the Interferon alpha (IFNα), there was a statistically significant increase. On comparing the leukocyte count before and after epidural anesthesia, there was a rise, which was not statistically significant. On comparing the lymphocyte, eosinophil, basophil, and monocyte count, there was a statistically significant drop. A significant increase in neutrophil count was seen following epidural anesthesia. CONCLUSION: IL-1 was significantly reduced, and IFNα was significantly increased during breast cancer procedures conducted under thoracic epidural anesthesia. TNF, IL-2, IL-6, and IL-10 levels were comparable. A considerable increase in neutrophil counts was linked to a significant decrease in lymphocyte, monocyte, eosinophil, and basophil counts, but the overall leukocyte count remained comparable. The possible interaction between anesthesia, the technique of surgery, leukocytes, and cytokine production may have substantial implications during breast cancer surgeries, which needs further evaluation.