Xenon Anesthesia Reduces TNFα and IL10 in Bariatric Patients

Abramo, Antonio Carlos; Salvo, Clelia Di; Baldi, Giacomo Giulio; Marini, Elena; Anselmino, Marco; Salvetti, Guido; Giunta, Francesco; Forfori, Francesco

doi:10.1007/s11695-011-0433-y

Cited by 9 publications

(10 citation statements)

References 22 publications

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“…Finally, 13 studies that included a total of 817 patients were selected for the analysis. [ 3 – 10 , 13 , 15 – 17 , 20 ] The evaluated trials included reports that were published through December 2017. The baseline characteristics of the pooled studies are summarized in Table 1 , which includes patient age and the American Society of Anesthesiologists (ASA) status, which anesthetic drugs were administered and what type of surgery was used, and the results that are relevant to the analysis.…”

Section: Resultsmentioning

confidence: 99%

“…During the past decade, a number of randomized controlled trials (RCTs) have been published that have compared the clinical efficacies of xenon and other volatile or intravenous anesthetics. [ 3 – 20 ] Although one meta-analysis [ 2 ] has summarized these individual studies, it contained some specific errors and failed to include important clinical data related to propofol.…”

Section: Introductionmentioning

confidence: 99%

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Clinical efficacy of xenon versus propofol

Xia

Fang

et al. 2018

Medicine

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Background:Interest in the anesthetic use of xenon, a noble gas, has waxed and waned for decades, and the clinical effects of xenon are still debated. We performed a meta-analysis to compare the clinical efficacy of xenon with that of propofol.Methods:Electronic searches were performed through December 2017 using various databases, including PubMed, Embase, and the Cochrane Library. We identified thirteen trials that included a total of 817 patients.Results:Patients treated with xenon had a lower bispectral index (BIS) (weighted mean difference (WMD): −6.26, 95% confidence interval (CI): −11.33 to −1.18, P = .02), a higher mean arterial blood pressure (MAP) (WMD: 7.00, 95% CI: 2.32–11.68, P = .003) and a lower heart rate (HR) (WMD: −9.45, 95% CI: −12.28 to −6.63, P < 0.00001) than propofol-treated patients. However, there were no significant differences between the 2 treatment groups in the effects of nondepolarizing muscular relaxants, the duration spent in the postanesthesia care unit (PACU) (WMD: −0.94, 95% CI: −8.79–6.91, P = .81), or the incidence of perioperative complications [assessed using the outcomes of postoperative nausea and vomiting (PONV) (relative risk (RR): 2.01, 95% CI: 0.79–5.11, P = .14), hypotension (RR: 0.62, 95% CI: 0.27 to 1.40, P = .25), hypertension (RR: 1.27, 95% CI: 0.73–2.21, P = .39) and bradycardia (RR: 1.00, 95% CI: 0.36–2.74, P = 1.00)].Conclusion:In this meta-analysis of randomized controlled trials, we found that xenon treatment resulted in a higher MAP, a lower HR, and a smaller BIS index than treatment with propofol.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of xenon versus propofol

Xia

Fang

et al. 2018

Medicine

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“…Anti-inflammatory ( 35 ) and antioxidative ( 36 ) properties of xenon are now well known. In the study by Portier et al ( 30 ) volatile anesthesia associated to hyper or hypoxemia did not induce significant changes in isoprostanes plasma concentrations.…”

Section: Discussionmentioning

confidence: 99%

The Modification and Performance of a Large Animal Anesthesia Machine (Tafonius®) in Order to Deliver Xenon to a Horse

Santangelo

Robin

Simpson³

et al. 2017

Front. Vet. Sci.

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IntroductionXenon, due to its interesting anesthetic properties, could improve the quality of anesthesia protocols in horses despite its high price. This study aimed to modify and test an anesthesia machine capable of delivering xenon to a horse.Materials and methodsAn equine anesthesia machine (Tafonius, Vetronic Services Ltd., UK) was modified by including a T-connector in the valve block to introduce xenon, so that the xenon was pushed into the machine cylinder by the expired gases. A xenon analyzer was connected to the expiratory limb of the patient circuit. The operation of the machine was modeled and experimentally tested for denitrogenation, wash-in, and maintenance phases. The system was considered to consist of two compartments, one being the horse’s lungs, the other being the machine cylinder and circuit. A 15-year-old, 514-kg, healthy gelding horse was anesthetized for 70 min using acepromazine, romifidine, morphine, diazepam, and ketamine. Anesthesia was maintained with xenon and oxygen, co-administered with lidocaine. Ventilation was controlled. Cardiorespiratory variables, expired fraction of xenon (FeXe), blood gases were measured and xenon was detected in plasma. Recovery was unassisted and recorded.ResultsFeXe remained around 65%, using a xenon total volume of 250 L. Five additional boli of ketamine were required to maintain anesthesia. PaO2 was 45 ± 1 mmHg. The recovery was calm. Xenon was detected in blood during the entire administration time.ConclusionThis pilot study describes how to deliver xenon to a horse. Although many technical problems were encountered, their correction could guide future endeavors to study the use of xenon in horses.

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“…In this line, two small randomized controlled trials enrolling obese surgical patients evaluated the effects of different anesthetic approaches (Table 1 ). Abramo et al[ 120 ] investigated the effects of total intravenous anesthesia (TIVA), inhalation anesthesia (sevoflurane), or xenon anesthesia on serum levels of proinflammatory cytokines (IL-6, IL-10, TNF-α) and NO. The authors observed that xenon anesthesia was superior to the other two strategies in inhibiting postoperative serum TNF-α concentrations, but found no differences in other mediators[ 120 ].…”

Section: Immunomodulatory Effects Of Anesthetics In Obesitymentioning

confidence: 99%

“…Abramo et al[ 120 ] investigated the effects of total intravenous anesthesia (TIVA), inhalation anesthesia (sevoflurane), or xenon anesthesia on serum levels of proinflammatory cytokines (IL-6, IL-10, TNF-α) and NO. The authors observed that xenon anesthesia was superior to the other two strategies in inhibiting postoperative serum TNF-α concentrations, but found no differences in other mediators[ 120 ]. The effects of ketamine on inflammatory and immune responses after short-duration procedures were similar to those previously reported in non-obese patients[ 121 ].…”

Section: Immunomodulatory Effects Of Anesthetics In Obesitymentioning

confidence: 99%

Immunomodulatory effects of anesthetics in obese patients

Heil

Silva

Pelosi

2017

WJCCM

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Anesthesia and surgery have an impact on inflammatory responses, which influences perioperative homeostasis. Inhalational and intravenous anesthesia can alter immune-system homeostasis through multiple processes that include activation of immune cells (such as monocytes, neutrophils, and specific tissue macrophages) with release of pro- or anti-inflammatory interleukins, upregulation of cell adhesion molecules, and overproduction of oxidative radicals. The response depends on the timing of anesthesia, anesthetic agents used, and mechanisms involved in the development of inflammation or immunosuppression. Obese patients are at increased risk for chronic diseases and may have the metabolic syndrome, which features insulin resistance and chronic low-grade inflammation. Evidence has shown that obesity has adverse impacts on surgical outcome, and that immune cells play an important role in this process. Understanding the effects of anesthetics on immune-system cells in obese patients is important to support proper selection of anesthetic agents, which may affect postoperative outcomes. This review article aims to integrate current knowledge regarding the effects of commonly used anesthetic agents on the lungs and immune response with the underlying immunology of obesity. Additionally, it identifies knowledge gaps for future research to guide optimal selection of anesthetic agents for obese patients from an immunomodulatory standpoint.

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Xenon Anesthesia Reduces TNFα and IL10 in Bariatric Patients

Cited by 9 publications

References 22 publications

Clinical efficacy of xenon versus propofol

Clinical efficacy of xenon versus propofol

The Modification and Performance of a Large Animal Anesthesia Machine (Tafonius®) in Order to Deliver Xenon to a Horse

Immunomodulatory effects of anesthetics in obese patients

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