The relevance of immunologic responses to anesthesia and surgery

Out of some three million general anesthetic (GA) procedures administered in the UK each year some 10,000 patients will suffer clinically a severe immediate hypersensitivity-type (anaphylactoid) response: some will suffer neurological deficit, a few will die. The problems are essentially those intrinsic to all intravenous administration and infrequently drug specific. The problems of local anesthesia (LA) are fewer and reflect accident, local and regional CNS and CVS toxicity effects and, less frequently, systemic response. The relative incidence of severe LA to GA reactions reported nationwide to Sheffield lies between 5% and 10% of the total reports. In the post-operative period the dramatic changes in laboratory parameters of immunity refer largely to the stress response to surgery and probably have little relevance to post-operative infection and wound healing in elective surgery.