Sevoflurane attenuates systemic inflammation compared with propofol, but does not modulate neuro-inflammation

Beck‐Schimmer, Beatrice; Baumann, Lukas; Restin, Tanja; Eugster, Philipp; Hasler, Melanie; Booy, Christa; Schläpfer, Martin

doi:10.1097/eja.0000000000000668

Cited by 24 publications

(20 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our comparison of propofol- and isoflurane-treated patients was limited by slight differences in age, hydromorphone dose, and BIS index (Table 1 ), though we believe that these slight differences between groups are unlikely to have obscured a biologically significant difference in cytokines levels. Our results are similar to those of Beck-Schimmer et al, who recently found no difference in LPS-induced neuroinflammation among rats treated with propofol vs. the inhaled anesthetic sevoflurane ( 26 ). However, due to insufficient prior literature comparing the human postoperative increase in CSF cytokines between propofol- vs. isoflurane-treated patients, we were unable to perform an a priori sample size calculation for this study.…”

Section: Discussionsupporting

confidence: 92%

The Effect of Propofol vs. Isoflurane Anesthesia on Postoperative Changes in Cerebrospinal Fluid Cytokine Levels: Results from a Randomized Trial

et al. 2017

View full text Add to dashboard Cite

IntroductionAside from direct effects on neurotransmission, inhaled and intravenous anesthetics have immunomodulatory properties. In vitro and mouse model studies suggest that propofol inhibits, while isoflurane increases, neuroinflammation. If these findings translate to humans, they could be clinically important since neuroinflammation has detrimental effects on neurocognitive function in numerous disease states.Materials and methodsTo examine whether propofol and isoflurane differentially modulate neuroinflammation in humans, cytokines were measured in a secondary analysis of cerebrospinal fluid (CSF) samples from patients prospectively randomized to receive anesthetic maintenance with propofol vs. isoflurane (registered with , identifier NCT01640275). We measured CSF levels of EGF, eotaxin, G-CSF, GM-CSF, IFN-α2, IL-1RA, IL-6, IL-7, IL-8, IL-10, IP-10, MCP-1, MIP-1α, MIP-1β, and TNF-α before and 24 h after intracranial surgery in these study patients.ResultsAfter Bonferroni correction for multiple comparisons, we found significant increases from before to 24 h after surgery in G-CSF, IL-10, IL-1RA, IL-6, IL-8, IP-10, MCP-1, MIP-1α, MIP-1β, and TNF-α. However, we found no difference in cytokine levels at baseline or 24 h after surgery between propofol- (n = 19) and isoflurane-treated (n = 21) patients (p > 0.05 for all comparisons). Increases in CSF IL-6, IL-8, IP-10, and MCP-1 levels directly correlated with each other and with postoperative CSF elevations in tau, a neural injury biomarker. We observed CSF cytokine increases up to 10-fold higher after intracranial surgery than previously reported after other types of surgery.DiscussionThese data clarify the magnitude of neuroinflammation after intracranial surgery, and raise the possibility that a coordinated neuroinflammatory response may play a role in neural injury after surgery.

show abstract

Section: Discussionsupporting

confidence: 92%

The Effect of Propofol vs. Isoflurane Anesthesia on Postoperative Changes in Cerebrospinal Fluid Cytokine Levels: Results from a Randomized Trial

et al. 2017

View full text Add to dashboard Cite

show abstract

“…17 In a lipopolysaccharide-induced sepsis model in rats, concentrations of MCP-1, interleukin-6, and cytokine-induced neutrophil chemoattractant protein-1 measured 3, 6, and 12 h after lipopolysaccharide infusion were lower in sevoflurane-treated rats compared with propofol-treated rats. 18 Koutsogiannaki and colleagues 19 showed that improved survival in sevoflurane-treated mice subjected to sepsis was associated with less apoptosis in the spleen. Sevoflurane reduced neutrophil apoptosis by a Fas death domain-Fas-associated death domain interaction.…”

Section: Potential Beneficial Effects Of Volatile Anaesthetics In Covmentioning

confidence: 99%

Sevoflurane, a sigh of relief in COVID-19?

Nieuwenhuijs-Moeke

Jainandunsing

Struys

2020

British Journal of Anaesthesia

View full text Add to dashboard Cite

“…In a randomized controlled multicentre trial of Beck et al with 460 patients addressing the effect of volatile versus intravenous anaesthetics on major complications after lung surgery no difference between the two anaesthesia regimens was evident (19,20). Importantly inhalational anaesthetics dose-dependently influence local inflammatory processes, partially reverse hypoxic pulmonary vasoconstriction and reduce alveolar clearance (19,21).…”

Section: Anaestheticsmentioning

confidence: 99%