The perioperative effect of anesthetic drugs on the immune response in total intravenous anesthesia in patients undergoing minimally invasive gynecological surgery

Abstract

Background : The specific mechanism of action of each anesthetic drug on the immune system is still incompletely known. It is important to know how the various anesthetics used in minimally invasive surgery (MIS) act on the inflammatory response because the choice of the anesthetic agent can influence the patient’s immune system. Aim : Evaluation of the effect of anesthetic drugs used for total intravenous anesthesia (Propofol and Midazolam) on the inflammatory response after minimally invasive gynecological surgery. Patients, Materials and Methods : The inflammatory response in 20 female patients who underwent minimally invasive gynecological surgery under which intravenous anesthesia was performed. Depending on the combination of anesthetics used, we subdivided the study group into two groups, Group 1 consisting of the patients ( n =10) who were given for total intravenous anesthesia, the combination with Midazolam+Fentanyl, and Group 2 ( n =10) the patients who received the combination of Propofol+Fentanyl, respectively. Surgical interventional procedures included day surgery: diagnostic and operative hysteroscopy, endometrial ablation, surgical treatment of vulvar disorders. Serological profiling of patients was performed by dosing the serum concentration of nucleotide-binding domain (NOD) and leucine-rich repeat protein 3 (NLRP3) inflammasomes, interleukin (IL)-6, tumor necrosis factor-alpha (TNF- α ), IL-10 before and two hours after the surgical procedure. Results : In our study, we found that in both groups of patients (Midazolam+Fentanyl – Group 1, Propofol+Fentanyl – Group 2), NLRP3 and cytokines concentrations in the serum were higher after MIS than those before MIS. Conclusions : It appears that both Midazolam and Fentanyl and Propofol and Fentanyl have an immunomodulatory action due to the anti-inflammatory effect of both anesthetics. Therefore, anesthesiologists must choose an anesthetic method that uses individualized anesthetic agents, depending on the patient’s immune status and disease.

Sodium-glucose cotransporter 2 inhibitor dapagliflozin prevents ejection fraction reduction, reduces myocardial and renal NF-κB expression and systemic pro-inflammatory biomarkers in models of short-term doxorubicin cardiotoxicity

“…After centrifugation, supernatants were collected and treated to the quantification of MyD88 [Human MyD88 ELISA Kit (ab171341); Abcam, Milan, Italy] and NLRP3 [Human NLRP3 ELISA Kit (OKEH03368); Aviva Systems Biology, San Diego, CA, USA]. For the human MyD88 ELISA, the sensitivity was <10 pg/ml and the range of detection was 156–10,000 pg/ml; for the human NLRP3 ELISA assay, the sensitivity was <0.078 ng/ml and the range of detection was 0.156–10 ng/ml ( 29 ).…”

Bibliometric Analysis of Anesthetic Drugs’ Effects on Immune Function- Current Knowledge, Hotspots and Future Perspectives

“…In this field, 292 institutions published papers and 410 inter-agency collaborations were established. The top five universities, based on the number of papers issued, were Harvard University (12), Boston Children's Hospital (10), Harvard Medical School (9), National Institute of Health and Medicine (Inserm) (7), and Fudan University (6). The National Institute of Health and Medical Research (Inserm) and Florida State University System Center were ranked first with a centrality score of 0.01 (Figure 4B), (Table S1).…”

“… 5 In 1981, Shapiro et al 6 discovered the involvement of anesthetics in the progression and metastasis of cancer. Novac et al 7 discovered that NLRP3 and cytokine concentrations in the serum were greater after minimally invasive surgery (MIS) than before MIS in both groups of patients (Midazolam+Fentanyl - Group 1, Propofol+Fentanyl - Group 2). Presently, numerous research groups are directing their attention towards the impact of anesthetic drugs on immune function, postoperative mortality, and recurrence rate of cancer surgery patients.…”

Recurrent hydatidiform moles: detection of a new mutation in the NLRP7 gene in the family

“…Focal trophoblastic hyperplasia is characterized by focal swelling of chorionic villas and triploid embryonic tissue. 2 The genetic material in the complete hydatidiform moles is entirely paternal. There is no maternal genetic contribution.…”