Update on anaesthesia and the immune response

Moudgil, G. C.

doi:10.1007/bf03019157

Cited by 32 publications

(24 citation statements)

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“…Previous research attributed the state of postoperative immunosuppression to effects on both the humoral and cellular arms of the immune system. The trauma of surgery is a significant factor in the observed postoperative immunodepression in normal individuals [3,4]. The greater the surgical trauma, the more profound the observed immunodepression [5].…”

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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 anaesthesia and surgery on plasma cytokine production

1999

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“…However, in infants delivered by cesarean section, the immune system could be in fluenced by drugs which, given to the mother for general anesthesia, cross the placenta and reach the fetal circulation [4] and have been reported to cause a depression of several im mune functions in adults [5,6],…”

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Neonatal B Lymphocyte Subpopulations and Method of Delivery

et al. 1992

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We studied four groups of healthy term newborn infants: (1) 11 infants born by vaginal delivery; (2) 11 infants born by elective cesarean section; (3) 10 infants born by emergency cesarean section with labor, and (4) 10 infants born by complicated vaginal delivery. Total and differential leukocyte counts, cortisol blood level, and B lymphocyte subpopulations (SmIg, sIgD, sIgM, CD 19, CD20, CD21, CD23) were evaluated in cord blood samples from the four infant groups. Furthermore, the Pentothal blood level was measured in infants born by elective cesarean section and in their mothers at delivery. Higher total and differential leukocyte counts and cortisol blood levels were observed in group 1 and 4 infants as compared with group 2 and 3 infants. A significant correlation was observed between cortisol blood level and leukocyte counts. The percentages of positivity to cell surface markers of B lymphocyte subpopulations were significantly higher in infants born by elective cesarean section. A negative significant correlation of thiopentone with sIgM and CD21 was observed. These data indicate a significant influence of method of delivery and of thiopentone on B lymphocyte subpopulations.

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“…Cardiovascular intolerability is also frequently seen [30,36]. Both drugs are reported to predispose to infection related to adverse effects on immune function, which may compromise the care of a patient already at serious risk of ventilator associated pneumonia and other infectious complications [30,37]. During infusion, serum barbiturate levels can be monitored although therapeutic endpoints should be based primarily on clinical and electrographic response.…”

Section: Emergency Treatment For Status Epilepticusmentioning

confidence: 99%

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2017

J Clin Intensive Care Med

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Update on anaesthesia and the immune response

Cited by 32 publications

References 41 publications

The effect of anaesthesia and surgery on plasma cytokine production

The effect of anaesthesia and surgery on plasma cytokine production

Neonatal B Lymphocyte Subpopulations and Method of Delivery

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