Endocrine, hematological and immunological changes in surgical patients undergoing general anesthesia

Some hematological endocrine, and immunological reactions in surgical patients under general anesthesia were studied. While serum cortisol, fT4, T4, rT3 levels increased, TBG, TSH, fT3 and T3 decreased. Cortisol increase and T3 and fT3 decrease were still significant three days after surgery. TSH and T3 decrease was significantly related to cortisol increase. CD4 (helper-inducer) cells dropped, rosettes, CD 5, CD 8, CD 16 (NK) and T HLA-DR (activated) number of cells did not change significantly. The decrease in CD 4 subset was significantly related to cortisol increase. Thus surgery was followed by a reduced thyroid function and decreased CD 4 subset. However this was observed also in the few patients in whom the serum cortisol level did not change. These reactions may represent immunosuppression occurring in the postoperative period.