Release mechanisms of postoperative changes in various acute phase proteins and immunoglobulins

Postoperative changes in various acute phase proteins (transferrin, albumin, prealbumin, orosomucoid, haptoglobin, IgA, IgG, and IgM), plasma glucose, and cortisol were studied in twelve otherwise healthy premenopausal women undergoing elective hysterectomy during either general anaesthesia or epidural analgesia (T4-S5). The results showed a 10-20% decrease of all proteins during the first postoperative day (p less than 0.05), followed by a gradual, significant increase of orosomucoid to 80% and of haptoglobin to 140% above preoperative levels on day seven after surgery in both groups. The other proteins remained significantly decreased during the second postoperative day, but returned to preoperative levels by day seven after surgery in both groups. Epidural analgesia blocked the normal postoperative increase in plasma glucose and cortisol. Plasma levels of transferrin, albumin, prealbumin, IgA, IgG, and IgM were significantly lower during the first postoperative day in the epidural group. It is concluded that postoperative changes in acute phase proteins are mediated by factors other than neurogenic stimuli and adrenal hormones.