The Effect of Anesthetic Agents on the Human Immune Response

Stevenson, G. W.; Hall, Steven C.; Rudnick, S A; Seleny, Frank L.; Stevenson, Henry C.

doi:10.1097/00000542-199003000-00024

Cited by 158 publications

(78 citation statements)

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“…Numerous studies (Kurosawa S, 2008) have shown that recently, alongside with immune suppression caused by surgical stress, anaesthetics and analgesic agents commonly used in surgery and in intensive care may directly affect the functions of immune-competent cells. Since the reactivation of HHV-6 and HHV-7 viral infection is more pronounced in patients of general anaesthesia group, our data are consistent with the previous studies that general anaesthesia does not suppress the surgical stress response, thus exacerbating postoperative immunosupression (Stevenson, 1990), (Lundy, 1978). Immunosupression is the main cause of the reactivation of HHV-6 and HHV-7 viral infection.…”

Section: Discussionsupporting

confidence: 92%

The Detection of Beta-Herpesvirus Infection in Patients undergoing Reconstructive Flap Surgeries and Its Association with the nearest Postoperative Period Course

Vilks¹,

Rasa²,

Krustins³

et al. 2011

Acta Chirurgica Latviensis

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Section: Discussionsupporting

confidence: 92%

The Detection of Beta-Herpesvirus Infection in Patients undergoing Reconstructive Flap Surgeries and Its Association with the nearest Postoperative Period Course

Vilks¹,

Rasa²,

Krustins³

et al. 2011

Acta Chirurgica Latviensis

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“…Anaesthetic and sedative agents may interfere with immune function [1,2]. During general anaesthesia, these immunomodulatory effects may be reversible because of the short period of administration.…”

mentioning

confidence: 99%

The immunomodulatory effects of prolonged intravenous infusion of propofol versus midazolam in critically ill surgical patients

Helmy

Al‐Attiyah

2001

Anaesthesia

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Both propofol and midazolam are known to inhibit immune function. The aim of this study was to investigate cytokine production in critically ill surgical patients as early markers of immune response to prolonged infusion of propofol and midazolam. The study enrolled 40 elective patients who were to receive long‐term sedation for more than 2 days. Patients were randomly allocated to one of two equally sized groups. Central venous blood samples for measurement of interleukin‐1β (IL‐1β), interleukin‐2 (IL‐2), interleukin‐6 (IL‐6), interleukin‐8 (IL‐8), tumour necrosis factor‐α (TNF‐α) and interferon‐γ (IFN‐γ) were drawn prior to the start and after 48 h of infusion. After 48 h, propofol caused significant increases in IL‐1β (24%), IL‐6 (23%) and TNF‐α (4.8 times) levels, while midazolam caused significant decreases in IL‐1β (21%), IL‐6 (21%) and TNF‐α (19%). Both agents caused significant decreases in IL‐8 levels (propofol: 30%, midazolam: 48%, p < 0.05). Propofol caused significant decreases in IL‐2 levels (68%, p < 0.001) but increases in IFN‐γ (30%, p < 0.05), whereas there was no significant change with midazolam compared with the pre‐infusion level. In conclusion, during 48 h of continuous infusion, propofol stimulated, while midazolam suppressed, the production of the pro‐inflammatory cytokines IL‐1β, IL‐6 and TNF‐α, and both caused suppression of IL‐8 production. Propofol inhibited IL‐2 production and stimulated IFN‐γ production, whereas midazolam failed to do so. Therefore, sedative agents may have clinical implications in high‐risk and immunocompromised patients.

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“…Many normal functions of the immune system are depressed after exposure to the combination of anaesthesia and surgery [1]. Several studies have suggested that impairment of the immune response might increase perioperative morbidity and mortality from infection in susceptible patients [2].…”

mentioning

confidence: 99%

The effect of anaesthesia and surgery on plasma cytokine production

1999

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SummaryThe aim of this study was to investigate cytokine production in response to anaesthesia [total intravenous anaesthesia (TIVA) with propofol, sufentanil and atracurium] and surgery (laparoscopic vs. open cholecystectomy). Forty adult patients, ASA I-II, undergoing elective laparoscopic (group 1) or open (group 2) cholecystectomy were studied. Venous blood samples for measurement of interleukin (IL)-1b, IL-2, IL-4, IL-6, tumour necrosis factor-a (TNF-a) and interferon-g (IFN-g) were taken before the induction of anaesthesia, pre-incisionaly, at the end of anaesthesia and surgery and 24-h postoperatively. Pre-incisionaly, in both groups, IL-1b, IL-4, IL-6, TNF-a and IFN-g did not show a significant change, whereas IL-2 showed a significant decrease (p < 0.005 in group 1 and p < 0.001 in group 2) compared with pre-induction levels. By the end of anaesthesia and surgery, IL-1b, IL-2, IL-4, IL-6 and TNF-a showed a significant increase in group 2 (p < 0.005 for IL-1b, IL-2 and IL-4, and p < 0.05 for IL-6 and TNF-a); while in group 1, only IL-2 showed a significant increase (p < 0.01) and IFN-g showed a significant decrease (p < 0.05) compared with pre-incisional levels. By 24-h postoperatively, IL-1b, IL-4, IL-6 and TNF-a had decreased significantly in group 2 (p < 0.005 for IL-4 and p < 0.05 for the others); whereas in group 1, IL-2 and IFN-g showed a significant increase (p < 0.005) compared with the end of anaesthesia and surgery level. In conclusion, TIVA with propofol, sufentanil and atracurium does not seem to have a significant effect on IL-1b, IL-4, IL-6, TNF-a and IFN-g release. IL-2 was the only cytokine to show a significant decrease due to the effect of anaesthesia alone in both groups. The cytokine response to open cholecystectomy stimulated both the pro-inflammatory (IL-1b, IL-6 and TNF-a) and the anti-inflammatory (IL-4) components, while this response was absent in laparoscopic cholecystectomy.

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The Effect of Anesthetic Agents on the Human Immune Response

Cited by 158 publications

References 0 publications

The Detection of Beta-Herpesvirus Infection in Patients undergoing Reconstructive Flap Surgeries and Its Association with the nearest Postoperative Period Course

The Detection of Beta-Herpesvirus Infection in Patients undergoing Reconstructive Flap Surgeries and Its Association with the nearest Postoperative Period Course

The immunomodulatory effects of prolonged intravenous infusion of propofol versus midazolam in critically ill surgical patients

The effect of anaesthesia and surgery on plasma cytokine production

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