Immunomodulatory Effects of Anesthetics during Thoracic Surgery

Mahmoud, Khaled; Ammar, Amany S

doi:10.1155/2011/317410

Cited by 29 publications

(38 citation statements)

References 22 publications

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“…Mahmoud et al [27] found that alveolar and plasma concentrations of IL-8 and TNF-α were significantly lower in patients undergoing thoracic surgical procedures under 1 MAC isoflurane anesthesia compared to patients who received propofol (4 – 6 mg/kg/h)-based anesthesia [27]. Similarly, De Conno et al [28] investigated the modulatory effect of sevoflurane on inflammation in 54 patients undergoing thoracic surgery.…”

Section: Introductionmentioning

confidence: 99%

Volatile anesthetics-induced neuroinflammatory and anti-inflammatory responses

Blum

Zuo

2013

Med Gas Res

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Volatile anesthetics have been the major anesthetics used clinically for more than 150 years. They provide all components of general anesthesia and are easy to be applied and monitored with modern equipment and technology. In addition to having anesthetic property, volatile anesthetics have multiple other effects. Many studies have clearly shown that volatile anesthetics can reduce systemic and local inflammatory responses induced by various stimuli in humans and animals. On the other hand, recent animal studies have shown that volatile anesthetics may induce mild neuroinflammation. These dual effects on inflammation may have significant biological implications and are briefly reviewed here.

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Section: Introductionmentioning

confidence: 99%

Volatile anesthetics-induced neuroinflammatory and anti-inflammatory responses

Blum

Zuo

2013

Med Gas Res

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“…Influencing the functions of immunocompetent cells and inflammatory mediator gene expression and secretion, most anesthetics have a direct suppressive effect on cellular and neurohumoral immunity [ 7 ]. Every anesthetic has different immunosuppressive effects, and researchers generally agree that total intravenous anesthesia (TIVA) is less immunosuppressive than inhalational anesthesia [ 11 ]. Most commonly used in veterinary medicine, propofol also has shown immunosuppressive effects, but fewer than the other volatile anesthetics; moreover, it has some protective influences on the immune system.…”

mentioning

confidence: 99%

A comparison of the immunological effects of propofol and isoflurane for maintenance of anesthesia in healthy dogs

Tomihari

Nishihara

Shimada

et al. 2015

The Journal of Veterinary Medical Science

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Most anesthetics have an immuno-suppressive effect on cellular and neurohumoral immunity, and research shows that total intravenous anesthesia (TIVA) with propofol has a greater immuno-protective effect than inhalational anesthesia in human medicine. However, in veterinary clinics, these effects remain ambiguous. To clarify the details, we focused on propofol and isoflurane, investigating clinical blood hematology and immunological profiles drawn from healthy dogs under and after two anesthesia techniques. Twelve healthy adult beagles were included in this study, randomly assigned to the propofol anesthesia group (group P: n=6) or the isoflurane anesthesia group (group I: n=6). In both groups, the number of lymphocytes in peripheral blood decreased after 2 hr of anesthesia (2 hr), but group P showed significantly less decrease than group I. For T-lymphocyte subsets examined by flowcytometry, the ratio of CD3+, CD4+ and CD8+ lymphocytes in the peripheral blood mononuclear cell (PBMC) of group P at 2 hr also exhibited a high level compared to group I. Moreover, for mRNA expression of cytokines measured by real-time PCR, the IL2 (pro-inflammatory cytokine) of group P showed no decrease like group I. The IL10 (anti-inflammatory cytokine) of group P also showed no increase like group I, while both cytokines maintained nearly the same level until 2 hr. These results suggest that, compared to propofol, isoflurane had more strongly immuno-suppression caused by anesthesia, and propofol itself might have some immuno-protective effects. Thus, TIVA with propofol might benefit immunological support in the perioperative period of dogs.

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“…Volatile anesthetics have been shown to induce dose and time-dependent immune-modulatory effects (35). Desflurane and sevoflurane suppress local alveolar cytokine pro-inflammatory release in the ventilated lung after OLV, while propofol seems not to produce this advantageous effect (36). In particular, volatile anesthesia with desflurane attenuates the immune response and causes, as compared to propofol, a minor alveolar release of inflammatory mediators such as ICAM-1, polymorphonuclear (PMN) A elastase, IL-8 and IL-10 (37).…”

Section: Discussionmentioning

confidence: 99%

Short-term one-lung ventilation does not influence local inflammatory cytokine response after lung resection

et al. 2018

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Background: One-lung ventilation (OLV) is a ventilation procedure used for pulmonary resection which may results in lung injury. The aim of this study was to evaluate the local inflammatory cytokine response from the dependent lung after OLV and its correlation to VT. The secondary aim was to evaluate the clinical outcome of each patient. Methods: Twenty-eight consecutive patients were enrolled. Ventilation was delivered in volume-controlled mode with a VT based on predicted body weight (PBW). 5 cmH 2 O positive end-expiratory pressure (PEEP) and FiO 2 0.5 were applied. Bronchoalveolar lavage (BAL) was performed in the dependent lung before and after OLV. The levels of pro-inflammatory interleukins (IL-1α, IL-1β, IL-6, IL-8), tumor necrosis factor alpha (TNFα), vascular endothelial growth factor (VEGF), endothelial growth factor (EGF), monocyte chemoattractant protein-1 (MCP-1) and anti-inflammatory cytokines, such as interleukins (IL-2, IL-4, IL-10) and interferon (IFN-γ), were evaluated. Subgroup analysis: to analyze the VT setting during OLV, all patients were ventilated within a range of 5-10 mL/kg. Thirteen patients, classified as a conventional ventilation (CV) subgroup, received 8-10 mL/kg, while 15 patients, classified as a protective ventilation (PV) subgroup, received 5-7 mL/kg.Results: Cytokine BAL levels after surgery showed no significant increase after OLV, and no significant differences were recorded between the two subgroups. The mean duration of OLV was 64.44±21.68 minutes.No postoperative respiratory complications were recorded. The mean length of stay was for 4.00±1.41 days in the PV subgroup and 4.45±2.07 days in the CV group; no statistically significant differences were recorded between the two subgroups (P=0.511). Conclusions: Localized inflammatory cytokine response after OLV was not influenced by the use of different VT. Potentially, the application of PEEP in both ventilation strategies and the short duration of OLV could prevent postoperative complications.

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Immunomodulatory Effects of Anesthetics during Thoracic Surgery

Cited by 29 publications

References 22 publications

Volatile anesthetics-induced neuroinflammatory and anti-inflammatory responses

Volatile anesthetics-induced neuroinflammatory and anti-inflammatory responses

A comparison of the immunological effects of propofol and isoflurane for maintenance of anesthesia in healthy dogs

Short-term one-lung ventilation does not influence local inflammatory cytokine response after lung resection

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