Comparison of the effects of four i.v. anaesthetic agents on polymorphonuclear leucocyte function

Abstract

Initial resistance of bacterial infection is mediated primarily by polymorphonuclear leucocytes (PMN). Anaesthetic agents have been reported to impair various aspects of PMN function. It is possible that the use of these agents to sedate critically ill patients may further compromise an already depressed host defence mechanism. A flow cytometric technique with fresh whole blood from 10 healthy volunteers was used. Phagocytic and respiratory burst activity of PMN incubated for 1 h with either propofol, thiopentone, midazolam or ketamine at both clinical plasma concentrations and 100 times this concentration were determined. Thiopentone at the higher concentration reduced both respiratory burst activity (mean peak channel 50.7 compared with control value of 77.6 (P < 0.0001)) and phagocytosis (mean peak channel 47.5 compared with 79.9 (P < 0.0001)). Ketamine at 100 times the clinical plasma concentration also reduced respiratory burst and phagocytosis, but this failed to reach statistical significance (P = 0.10 and P = 0.053, respectively). No significant depression occurred in the other groups. The results suggest that these i.v. anaesthetic agents, at clinically relevant concentrations, have minimal effects on PMN phagocytosis and oxygen free radical production. At higher concentrations thiopentone and ketamine may affect phagocytic function and thiopentone may impair intracellular cytolysis.

Propofol Inhibits Superoxide Production, Elastase Release, and Chemotaxis in Formyl Peptide–Activated Human Neutrophils by Blocking Formyl Peptide Receptor 1

“…Propofol impairs the chemotaxis and respiratory burst of neutrophils in response to fMLF (12,13). However, other research revealed that propofol fails to alter respiratory burst in PMA-activated neutrophils (14). Indeed, the cellular mechanisms responsible for the pharmacological effects of propofol in human neutrophils are controversial and remain to be established.…”

Effect of ovariohysterectomy on canine postsurgical leukocyte function

“…Nishina et al (1998) found that thiopental, midazolam and ketamine impaired chemotaxis, phagocytosis and oxygen radicals production. The results of Duncan and Cullen (1977) and Davidson et al (1995) suggest that halothane, propofol, thiopentone, midazolam and ketamine have minimal effects on phagocytosis, only extremely high and clinically irrelevant concentrations of thiopentone and ketamine may affect phagocytic function. Alteration of phagocytic abi lity was found in animals in the study by Paulík et al (1999) after excision of skin papillomas in calves using anaesthesia with xylazine and procaine.…”

“…The depression of cell-mediated immunity can develop in various degrees and is usually dependent on the kind of anaesthetic, its dose and on the extent of surgical trauma. Various anaesthetics (propofol, thiopentone, midazolam, ketamine) are known to depress human neutrophil functions (Salo, 1989;Davidson et al, 1995;Mikawa et al, 1998;Nishina et al, 1998). Depression of lymphocyte function was studied after the use of thiopentone, methohexitone, etomidate, and pheno-Acta Veterinaria Hungarica 51, 2003 barbitone (Puppo et al, 1980;Devlin et al, 1994).…”

Anesthesia, cytokines and cancer recurrence

“…In healthy volunteers, thiopentone and etomidate impair lymphocytes function [84]. Thiopentone may have no effect on IL-2 [93], but it decreases INF-y [93,98], IL-4 [93] and INF-y/IL-4 ratio [93], and impairs chemotaxis [99] and phagocytosis [88, 99,100]. Similarly, midazolam inhibits chemotaxis [99] and IL-8 secretion [90].…”