Influence of combined neural blockade, H1- and H2-receptor and serotonin2-receptor blockade, indomethacin and tranexamic acid on leucocyte, temperature and acute-phase protein response to surgery.

Body temperature, P-cortisol, P-glucose, P-transferrin, P-orosomucoid, P-IgM, hematocrit and total and differential leucocyte counts were investigated in 16 men undergoing inguinal herniotomy. The patients were randomized to epidural analgesia (n = 8) or epidural analgesia + assumed blockade of prostaglandin synthesis, blockade of receptors for histamine1, histamine2 and serotonin2, and inhibition of fibrinolysis with indomethacin, astemizole, ranitidine, ketanserin and tranexamic acid, respectively (n = 8). The rectal temperature and blood granulocyte counts rose significantly and similarly after surgery in both groups. Acute-phase protein (transferrin and orosomucoid) changes were also similar in both groups, as were P-cortisol and P-glucose, which did not increase in response to the neural blockade. Other factors than neural stimuli, prostaglandins, histamine, serotonin and activation of fibrinolysis are concluded to be effective in releasing postoperative leucocytosis, rise in body temperature and changes in acute-phase proteins.