Effects of sevoflurane and propofol on pulmonary inflammatory responses during lung resection

Sugasawa, Yusuke; Yamaguchi, Kazuya; Kumakura, Seiichiro; Murakami, Tatsuya; Suzuki, Kenji; Nagaoka, Isao; Inada, Eiichi

doi:10.1007/s00540-011-1244-y

Cited by 45 publications

(37 citation statements)

References 40 publications

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“…Furthermore, according to Franke et al, [22] the IL-8 levels were selectively elevated after cardiac surgery, and the myocardium was identified as the major source of this cytokine. Additionally, Sugasawa et al [24] identified elevated IL-8 levels in BAL specimens taken after lung surgery, which is contrary to our results. However, they also found increased levels of IL-6 and TNF-a when bronchial lavage was performed after lung surgery just as we did.…”

Section: Discussioncontrasting

confidence: 99%

“…In addition, we investigated the bronchial inflammatory process of the affected lung before and after surgery and the contralateral lung preoperatively. Numerous articles have been published regarding the effect of anesthesia type on cytokines, [11][12][13][14] but in our study, all of the patients received similar forms of anesthesia, and the operation times did not vary significantly.…”

Section: Discussionmentioning

confidence: 67%

See 1 more Smart Citation

Bronchial cytokine level changes in lung cancer operations

Kuman¹

2014

Turk Gogus Kalp Dama

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Amaç: Bu çalışmada akciğer rezeksiyon tipinin, lenfovasküler invazyonun ve kanser türünün bronşiyal sitokin düzeyleri üzerine [interlökin (IL)-6, IL-8 ve tümör nekroz faktör-alfa (TNF-a)] etkileri değerlendirildi. Ça lış mapla nı:Ağustos 2010 -Aralık 2011 tarihleri arasında akciğer kanseri nedeniyle akciğer rezeksiyonu uygulanan 28 hasta (27 erkek, 1 kadın; ort yaş 65.9±7.6 yıl; dağılım 48-79 yıl) çalışmaya alındı. Hiçbirinde ateş, ampiyem veya alt solunum yolu enfeksiyonu bulguları yoktu. Bronş lavajı örnekleri hemen ameliyat öncesi ana bronş sistemlerinin her iki tarafından ve hemen ameliyat sonrası ameliyat edilen ana bronştan toplandı. Bul gu lar: Ameliyat öncesi her iki bronşiyal bölgeden alınan bronş sitokinleri arasında (tümörü olan ve olmayan) anlamlı farklılık gözlenmedi. Tümör tarafı bronşiyal IL-6 ve TNF-a düzeyleri ameliyat öncesi düzeyler (p= 0.001, p= 0.045) ile karşılaştırıldı-ğında, ameliyat sonrası anlamlı ölçüde artmıştı. Pnömonektomi uygulanan hastalarda IL-6 düzeyleri lobektomiye kıyasla yüksek bulundu (p= 0.004). İlave bir cerrahi işlem olarak dekortikasyon yapılan hastalar ile izole sadece akciğer rezeksiyonu uygulanan hastaların ameliyat öncesi kontralateral bronşiyal IL-8 düzeyleri arasında anlamlı farklılık gözlendi (p= 0.017). Evre, evre alt grubu ile ameliyat öncesi kontralateral bronşiyal IL-6 düzeyi (p= 0.005, p= 0.027) arasında pozitif ilişki vardı. Ameliyat sonrası IL-6 düzeyleri lenfovasküler invazyon saptanan (p= 0.008) hastalarda daha yüksek bulundu. So nuç: Ameliyat sonrası bronşiyal sistem tümör tarafı bronşiyal sitokin IL-6 ve TNF-a düzeyleri cerrahi travmanın bir göstergesi olabilir. Tümör evresi arttıkça, tüm akciğer etkilenir ve enflamatuvar yanıt kontralateral hemitoraksa kadar yayılır. Ameliyat sonrası IL-6 düzeyleri lenfovasküler invazyonun bir göstergesi olabilir. Ameliyatın büyüklüğüne göre enflamatuvar yanıt etkilenmektedir; pnömonektomi uygulanan hastaların IL-6 düzeyleri lobektomilere kıyasla anlamlı düzeyde yüksek seyredebilir. Bu sonuç, IL-6 sentezi ve cerrahi travma derecesi arasındaki ilişkiyi göstermektedir.Anah tar söz cük ler: Bronşiyal sitokinler; akciğer kanseri; lenfovasküler invazyon; rezeksiyon.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 67%

Bronchial cytokine level changes in lung cancer operations

Kuman¹

2014

Turk Gogus Kalp Dama

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“…Notably, it has already been reported that the levels of cytokines and chemokines (TNF-α, IL-8, IL-1β, IL-10 and IL-12p70) are increased in the ELF, however, these cytokine/chemokine levels remained undetectable in the plasma even following OLV and thoracic surgery (lobectomy and partial lung resection) (47). Thus, we hypothesize that the inflammatory response observed in the present study is restricted to the local airway surface.…”

Section: Sevoflurane Group (N=26) Propofol Group (N=26) -------------supporting

confidence: 41%

Effects of nitrous oxide on the production of cytokines and chemokines by the airway epithelium during anesthesia with sevoflurane and propofol

Kumakura

Yamaguchi

Sugasawa

et al. 2013

Molecular Medicine Reports

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Abstract. The aim of this study was to evaluate the effects of nitrous oxide (a gaseous anesthetic) on the in vivo production of inflammatory cytokines and chemokines by the airway epithelium, when combined with sevoflurane or propofol. Subjects undergoing simple or segmental mastectomy were randomly assigned to the sevoflurane and nitrous oxide, sevoflurane and air, propofol and nitrous oxide, or propofol and air group (all n=13). Epithelial lining fluid (ELF) was obtained using the bronchoscopic microsampling method prior to and following the mastectomy to enable measurement of the pre-and post-operative levels of certain inflammatory cytokines and chemokines using a cytometric bead array system. Notably, the levels of interleukin (IL)-1β, IL-8 and monocyte chemotactic protein-1 (MCP-1) in the ELF were significantly increased following the operations which involved the inhalation of sevoflurane and nitrous oxide, although the levels of these molecules were not significantly changed by the inhalation of sevoflurane and air. Furthermore, the IL-12p70 levels were significantly reduced in the ELF following the operations that involved the inhalation of sevoflurane and air, although the IL-12p70 levels were not significantly changed by the inhalation of nitrous oxide and sevoflurane. These observations suggest that the combination of sevoflurane and nitrous oxide induces an inflammatory response (increased production of IL-1β, IL-8 and MCP-1) and suppresses the anti-inflammatory response (reduced production of IL-12p70) in the local milieu of the airway. Thus, the combination of these compounds should be carefully administered for anesthesia. IntroductionGlobally, >200 million major surgical procedures are undertaken annually (1), and nitrous oxide is widely used in anesthesia, often administered at an inspired concentration of ~60-70% (2-5). Nitrous oxide has achieved marked longevity as an anesthetic, having been used widely since 1844 (6). However, the low toxicity of modern anesthetic agents and the accumulating evidence on the adverse effects of nitrous oxide render the continued use of nitrous oxide in anesthesia controversial (7-10). A number of the adverse effects of nitrous oxide result from the irreversible inactivation of vitamin B 12 , which inhibits methionine synthase, folate metabolism and deoxyribonucleic acid synthesis (7,8). This mechanism explains the megaloblastic anemia and neurologic toxicity associated with prolonged nitrous oxide administration (11,12), and the possible risk of teratogenicity, immunodeficiency and impaired wound healing (7,13,14). In addition, the inhibition of methionine synthase is associated with increased plasma homocysteine concentrations (15,16) which may increase the risk of post-operative cardiovascular complications (15). Furthermore, nitrous oxide impairs cerebral blood flow-activity coupling (10), and worsens the air space conditions (such as pneumothorax and air embolism) and bowel distension (8,9). Nitrous oxide is also a risk factor for post-operative nausea an...

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“…Obviously, these first clinical observations can only be regarded as preliminary (pilot study) and more studies are needed, both for confirmation as well as to clarify any associated clinical significance [39]. Of note, several recent studies compared the effects of propofol and volatile agents on perioperative inflammation [40][41][42]. Considering our results, further focus on the role of the lipid solvent in the perioperative inflammation seems justified [43].…”

Section: Propofolmentioning

confidence: 75%

Propofol and perioperative inflammation-the Intralipid® solvent may play a role

Bandschapp¹,

Chenaud²,

Inan³

et al. 2015

Glob Anesth Perioper Med

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The inflammatory properties of propofol are still debated. Apolipoprotein A-I is involved in the inflammation. We sought to determine how propofol or its solvent Intralipid® modulate Apolipoprotein A-I and the inflammatory response after surgical stress. Patients undergoing laparoscopic inguinal hernia repair were allocated to anesthesia with propofol (n=25), isoflurane alone (n=27) or in combination with Intralipid® (n=27). Apolipoprotein A-I and inflammation were assessed before, during and after surgery. Following a decrease in all groups, Apolipoprotein A-I levels tended to recover significantly earlier when propofol or Intralipid® were given (p<0.05). Cortisol increased in the control group whereas it remained at baseline levels when lipids were given. In this study the administration of lipids, i.e. propofol or its solvent Intralipid®, in the perioperative setting was associated with a more pronounced yet rapidly recovering acute phase reaction.

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Effects of sevoflurane and propofol on pulmonary inflammatory responses during lung resection

Cited by 45 publications

References 40 publications

Bronchial cytokine level changes in lung cancer operations

Bronchial cytokine level changes in lung cancer operations

Effects of nitrous oxide on the production of cytokines and chemokines by the airway epithelium during anesthesia with sevoflurane and propofol

Propofol and perioperative inflammation-the Intralipid® solvent may play a role

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