Recovery of respiratory ciliary function after depression by inhalation anaesthetic agents: an in vitro study using nasal turbinate explants

Abstract

We have developed a human tissue preparation suitable for measurement of cilia beat frequency derived from nasal turbinates. Cilia beat frequency of turbinate explants from 11 patients did not change significantly over a 10-day observation period while maintained in an incubator, with mean cilia beat frequency of 13.1 (SEM 0.3) Hz to 14.4 (0.2) Hz (ANOVA for repeated measures, P = 0.168). We have used this preparation to investigate recovery of ciliary function after depression by inhalation anaesthetic agents. Eight or nine turbinate explants were exposed to three times the minimum alveolar concentration (MAC) of halothane, enflurane or isoflurane for a period of 1 h and thereafter to a period of air washout. After exposure to the inhalation agent there was a significant reduction in cilia beat frequency with all three agents: halothane 14.3 (0.4) Hz to 9.5 (0.3) Hz; enflurane 13.7 (0.6) Hz to 10.5 (0.5) Hz;isoflurane 15.9 (0.6) Hz to 10.6 (0.3) Hz. Cilia beat frequency returned to values after air washout that were not significantly different from baseline after 90 min of washout of halothane and 60 min of washout of enflurane and isoflurane (repeated measures ANOVA, unpaired t test; P = 0.01 at 60 min and P = 0.31 at 90 min washout for halothane; P = 0.83 at 60 min washout for enflurane; P = 0.26 at 60 min washout for isoflurane).

The Effect of Low-Flow Desflurane Anesthesia on Mucociliary Clearance

“…It has been shown that high oxygen concentrations, dry anesthetic gases, trauma due to aspiration procedures and the cuff of the endotracheal tube may lower mucociliary clearance. [14][15][16][17][18][19][20][21] In addition, volatile anesthetics inhibit ciliary motility and impair bronchociliary clearance in a time and dosedependent manner. As a result of mucociliary impairment in the postoperative period, the rate of atelectasis and lower respiratory tract infections increases due to the retention of secretions.…”

“…[2,18] In vivo and in vitro studies of the volatile anesthetics, halothane, enflurane, isoflurane and desflurane, and of the IV anesthetic, pentothal have shown them to be responsible for the decrease in mucociliary transport. [18,19] In a study by Raphael et al, it was shown that 3 MAC of halothane, enflurane and isoflurane reversibly decreased the ciliary beat frequency. [19] These findings show that volatile anesthetics have negative effects on mucociliary functions.…”

“…[18,19] In a study by Raphael et al, it was shown that 3 MAC of halothane, enflurane and isoflurane reversibly decreased the ciliary beat frequency. [19] These findings show that volatile anesthetics have negative effects on mucociliary functions.…”

Assessment of nasal mucociliary clearance in anesthetists

“…Previous studies have shown anesthesia impairs mucociliary function in humans and animals and in vitro (12,16,17). Volatile anesthetics such as halothane, enflurane, isoflurane, and desflurane, and i.v.…”

Diagnostik der primären Ziliendyskinesie

“…Grundsätzlich ist es wichtig, dass die Untersuchungen in einem infektfreien Intervall durchgeführt werden, da eine Infektion des Atemtraktes zu einer Reduzierung der Zilienschlagfrequenz oder zum transienten Verlust der Zilien führen kann. Lokalanästhetika können Zilien funktionell hemmen[10] und so physiologische Parameter beeinflussen. Beim Bürstenabstrich aus der Nase wird unter Drehbewegung mit einer weichen Nylonbürste aus dem lateralen Anteil der Concha nasalis inferior bzw.…”