Halothane Anesthesia Decreases Human Monocyte Hydrogen Peroxide Generation. Protection of Monocytes by Activation with Gamma Interferon

Stevenson, G. W.; Hall, Steven C.; Rudnick, S. J.; Alvord, Gregory; Rossio, Jeffrey L.; Urba, Walter J.; Leventhal, J. R.; Miller, Paul J.; Seleny, Frank L.; Stevenson, Henry C.

doi:10.3109/08923978709035228

Cited by 14 publications

(8 citation statements)

References 18 publications

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“…Halothane has been reported to suppress the release of gamma-interferon from T cells (18). This study is supported by others which report a protective effect by gamma-interferon on either monocytes (19) or natural killer cells (20) treated with halothane. In addition, halothane has been demonstrated to increase intracellular cyclic AMP levels in lymphocytes (21).…”

Section: Discussionsupporting

confidence: 79%

Halothane Inhibits T Cell Proliferation and Interleukin-2 Receptor Expression in Rats

Hamra

Yaksh

1996

Immunopharmacology and Immunotoxicology

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In order to determine the effects of halothane on rat cell-mediated immune function, rats were exposed to 1% halothane for up to 5 hours. Immediately, 24 hours or 48 hours following anesthesia, rat lymphocytes from the spleen were analyzed for their ability to respond to the mitogens phytohemagglutinin (PHA), pokeweed mitogen (PWM), concanavalin A (ConA) and lipopolysaccharide (LPS). In addition, percentages of lymphocyte subpopulations in the spleen were assessed as well as ability of the lymphocytes to express specific receptors. Extended periods of halothane anesthesia (5 hours) suppressed the ability of the lymphocytes to respond to the mitogen PHA immediately following anesthesia. Twenty-four hours later, proliferative responses to the mitogens PHA, PWM and ConA were significantly reduced. However, by 48 hours following treatment, proliferative responses were normal. Halothane did not alter proliferative responses to the mitogen LPS. Prolonged anesthesia (5 hours) also increased the percentage of T and CD8+ (cytotoxic) lymphocytes in the spleen, although for less than 24 hours. The ability of T lymphocytes to express both the CD8 and CD25 (IL-2) receptors in response to PHA were suppressed. These results suggest that halothane suppresses rat T cell function, perhaps through suppression of IL-2 receptor expression.

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Section: Discussionsupporting

confidence: 79%

Halothane Inhibits T Cell Proliferation and Interleukin-2 Receptor Expression in Rats

Hamra

Yaksh

1996

Immunopharmacology and Immunotoxicology

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“…In contrast, it was suggested that there may be some benefit from infusing cytokines, such as IFN-a and IFN-b, and IL-2 on natural killer cell activity [4,35], which may be useful in immunocompromised patients. It was also shown that concomitant exposure of monocytes to IFN-g was protective against halothane-mediated immunosuppression [36]. Defects in IL-2 production have been observed in a number of diseases, including acquired immunodeficiency syndrome (AIDS), chronic infectious diseases and autoimmune diseases.…”

Section: Discussionmentioning

confidence: 99%

Effects of intrathecal ketamine added to bupivacaine for spinal anaesthesia

et al. 2000

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We prospectively studied 30 healthy female patients undergoing intracavitory brachytherapy applicator insertion for carcinoma of the cervix under spinal anaesthesia. Patients were randomly allocated to receive either intrathecal bupivacaine 10 mg alone or bupivacaine 7.5 mg combined with preservative-free ketamine 25 mg. Spinal block onset, maximum sensory level, duration of blockade, haemodynamic variables, postoperative analgesic requirements and adverse events were recorded. Onset of sensory and motor block and duration of spinal analgesia were comparable between groups. Duration of motor blockade was shorter (p 0.0416) and requirement for intravenous fluids in the peri-operative period was less (p 0.0159) in the ketamine group. Significantly more patients in the ketamine group had adverse events, such as sedation, dizziness, nystagmus,`strange feelings' and postoperative nausea and vomiting. Although the addition of ketamine to spinal bupivacaine had local anaesthetic sparing effects, it did not provide extended postoperative analgesia or decrease the postoperative analgesic requirements. Moreover, the central adverse effects of ketamine limit its spinal application. Reducing the dose of bupivacaine used in spinal anaesthesia helps to achieve rapid anaesthetic recovery but may result in anaesthetic failure [1]. Intrathecal adjuncts, such as opioids [2], vasoconstrictors [3], alpha-2 agonists [4], and neostigmine [5] are often added to enhance spinal anaesthesia. Even though these adjuncts are effective in improving the efficacy of low-dose spinal anaesthesia, their use is limited because of side-effects [2±5].Ketamine is an anaesthetic agent with potent analgesic properties. Its mode of action includes noncompetitive antagonism at N-methyl d-aspartate (NMDA) receptors and a local anaesthetic effect [6]. Intrathecal ketamine has been evaluated as a sole anaesthetic agent [7,8], but psychomimetic disturbances and inadequate analgesia precluded its use for this purpose. In this study, we evaluated the effects of intrathecal ketamine added to a small dose of spinal bupivacaine in patients with carcinoma of the cervix undergoing intracavitory brachytherapy applicator insertion. MethodsAfter obtaining approval from our Institutional Ethics Committee and informed patient consent, we enrolled 60 female, ASA physical status I or II patients with carcinoma of the cervix undergoing intracavitory brachytherapy implants (ovoids and tandems) insertion under spinal anaesthesia. Patients were randomly allocated to receive q 2000 Blackwell Science Ltd 899 either intrathecal hyperbaric bupivacaine 10 mg alone (0.5% Sensorcaine in 8.25% dextrose; Astra-IDL, India) or bupivacaine 7.5 mg with preservative-free ketamine 25 mg (Aneket 5%, Neon Laboratories, India). The patients and the doctor who observed the patients in the recovery room were blinded to the treatment.The Verbal Numerical Scores (VNS) system for assessment of pain was explained during the pre-operative visit. Patients were fasted for 6 h pre-operatively and premed...

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“…3,4 Several anaesthetic agents are able to affect the pattern of cytokine production by monocytes/ macrophages in vitro, including TNF, and several reports have confirmed that the confirmed adminis.tration of anaesthetics, profoundly derange the normal functions of the immune system in vivo. [5][6][7][8][9] Here, the results of experiments are reported, which indicate that anaesthetic drugs, most notably Pentothal, could strongly enhance under in vitro conditions the TNF production by peripheral blood mononuclear cells (PBMCs) from healthy individuals as compared to both lipopolysaccharide (LPS) treated and control cells. In addition, in in vivo studies the authors found that serum levels of TNFo are significantly increased following surgery.…”

Section: Introductionmentioning

confidence: 95%

Anaesthetics modulate tumour necrosis factor α: effects of L‐carnitine supplementation in surgical patients. Preliminary results.

Delogu

Simone

Famularo

et al. 1993

Mediators of Inflammation

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Both anaesthetics and surgical trauma could strongly affect the production of tumour necrosis factor α (TNFα). During in vitro experiments the authors found that anaesthetics modulate the production of TNFα by peripheral blood mononuclear cells. Notably, Pentothal strongly increased the production of the cytokine as compared to both lipopolysacchride treated and control mononuclear cells, whereas in supernatants from Leptofen driven mononuclear cells TNFα was strongly reduced. On the other hand, Pavulon did not significantly affect the cytokine production. In the in vivo study, in an attempt to ameliorate the metabolic response to surgical trauma, L-carnitine was administered to 20 surgical patients, then the circulating TNFα was measured. The results indicate that the levels of circulating TNFα were strongly increased following surgery and that L-carnitine administration resulted in a strong reduction of TNFα. Thus, the data suggest that L-carnitine could be helpful in protecting surgical patients against dysmetabolism dependent on dysregulated production of TNFα.

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Halothane Anesthesia Decreases Human Monocyte Hydrogen Peroxide Generation. Protection of Monocytes by Activation with Gamma Interferon

Cited by 14 publications

References 18 publications

Halothane Inhibits T Cell Proliferation and Interleukin-2 Receptor Expression in Rats

Halothane Inhibits T Cell Proliferation and Interleukin-2 Receptor Expression in Rats

Effects of intrathecal ketamine added to bupivacaine for spinal anaesthesia

Anaesthetics modulate tumour necrosis factor α: effects of L‐carnitine supplementation in surgical patients. Preliminary results.

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