Do anaesthetics and surgical stress increase the risk of post-exposure rabies treatment failure?

Immunization and anesthesia – an international survey

“…A case report by Fescharek et al . (20) suggested that ketamine anesthesia was implicated in a 6‐year‐old boy's failure of postexposure rabies immunization and subsequent death, although alternative explanations for the treatment failure were postulated later (21). However, the possibility of anesthesia and surgery contributing to rabies immunization failure led Çeliker et al (22) to postpone elective tonsillectomy in a child until postexposure immunization was complete.…”

Effects of four anaesthetics on the innate immune response of gilthead seabream ( L.)

“…Anaesthesia may have immunodepressive e#ects in mammals [6][7][8][9]25], but no attempts have been made to detect anaesthesia-induced immunodepression in fish. The present paper then, provides some novel information based on …”

“…In many cases their e#ectiveness depends on the procedure used, because severe anaesthesia may itself induce a stress response in fish [3,4], and stress is known to be a risk factor that may lead to immunodepression, thus facilitating subsequent infections [2,5]. While immunodepressive e#ects caused by anaesthesia have frequently been described in mammals [6][7][8][9], there are no studies on this topic in fish.…”

Rabies vaccine and neuraxial anaesthesia

“…3 Apart from these reasons for PEP failure, ketamine anaesthesia has been mentioned as an additional risk factor for treatment failure. 4 Although uneventful general anaesthesia for surgery after a dog bite has been reported, the use of central neuraxial blockade has not been reported to date. 5 The main concern in our patient was the probability of a reduction in the ef cacy of the vaccination due to the immunosuppressive effect of anaesthesia and surgery.…”