The Effects of Isoflurane and Sevoflurane on Immune System in Minor Surgical Interventi̇ons

Abstract

In the present state of knowledge, anaesthesia and surgery depress immune system by direct effects of anesthetic agents and indirect interaction of hormonal and metabolic changes caused by surgical stress. Every component of immunologic profile can be altered during anaesthesia and sur- - Hematological and most of the immunological measurements were in normal ranges throughout the study and no statistically significant difference was observed between sevoflurane and isoflurane groups. Time related differences observed in each group consisting increases in IgG, B and T lymphocytes and T-helper and decrease in T-suppressor levels with protection of complement levels in isoflurane group. Although the laboratory data showed better immune response for isoflurane, statistical analyses did not support these findings. Even though different aspects of immune system changes have been in the advantage of isoflurane regarding laboratory data, statistical methods did not revealed a meaningful difference in each comparison.K Ke ey y W Wo or rd ds s: Immune Response, Isoflurane, Minor Surgery, Sevoflurane, Ö ÖZ ZE ET T M Mi in nö ör r C Ce er rr ra ah hi i G Gi ir ri iş şi im ml le er rd de e İ İs so of fl lo or ra an n v ve e S Se ev vo of fl lo or ra an nı ın n İ İm mm mü ün n S Si is st te em me e E Et tk ki il le er ri i Anestezi ve cerrahinin immün sisteme olan etkileri uzun süredir bilinmektedir ve immün etkileşim girişimlerin morbiditesini arttırabilmektedir. Prospektif çalışmamızda sık kullanılan inhalasyon anestetikleri sevofloran ve izofloranın minör cerrahi uygulanan hastalarda immunolojik etkilerini karşılaştırmayı planladık. İmmünolojik yetmezliği olmayan ve minör cerrahi girişim uygulanan 44 hasta çalışmaya dahil edildi.Aynı indüksiyon tekniği uygulandıktan sonra 22 hastaya izofloran ve 22 hastaya sevofloran uygulandı.Kan örnekleri preoperatif ve postoperatif 1 ve 3. Günlerde olmak üzere 3 kez alındı. Laboratuvar incelemelerde lökosit sayımı, serum immunglobulinler, kompleman, lenfositler, T-lenfosit ve alt grupları bakıldı. İzofloran ve sevofloran grupları arasında hematolojik ve çoğu immünolojik ölçümler normal sınırlar içindeydi ve istatistiksel fark yoktu.A An na ah ht ta ar r K Ke el li im me el le er r: : İmmün Yanıt, İzofloran, Minor Cerrahi, Sevofloran

Anaesthesia and Stress Response to Surgery

“…Although the differences were insignificant, these results gave the idea that isoflurane caused less immunosuppression. (Durlu et al, 2002). In contrast, in the clinical setting of low stress laparoscopic surgery, the type of volatile anesthetic has been shown to significantly affect the stress response; the changes associated with sevoflurane suggested a more favourable metabolic and immune response compared to isoflurane (Marana et al, 2003).…”

Immunological Effects of Propofol, Ketamine and Isoflurane in Dexmedetomidine and Butorphanol Premedicated Dogs

“…Most of the anaesthetic agents caused immune suppression by influencing the functions of immunocompetent cells and inflammatory mediator gene expression and secretion (Kurosawa and Kato, 2008). Major surgeries also had effects on the immune system which were related to the extent of surgical trauma and the neuroendocrine stress response (Pirttikangas et al, 1995).Anaesthetic agents depressed the immune response by influencing phagocytic activity, lymphocyte transformation and cytokine production which can further increase the morbidity of procedures (Durlu et al, 2002). Therefore, the present study was carried out to evaluate the effect of Propofol, Ketamine and Isoflurane anaesthesia in Dexmedetomidine and Butorphanol premedicated dogs undergoing ovariohysterectomy in dogs.…”

Perioperative effects of co-administration of tci propofol combined with clonidine and ketamine

“…This happens because anesthesia provides sympathetic and afferent nerve fibers block that modulate the pituitary-adrenocortical system. 2,3 Total intravenous anesthesia (TIVA) by giving propofol in combination with opioids, administrated by TCI (target controlled infusion), are currently popular in the practice of anesthesia.…”

“…Clonidine is an alpha-2 agonist often used as a premedication due to its various effects, like sedation, analgesia, sympatholytic, and may reduce the dose of volatile or intravenous anesthetics. 3,4 Ketamine is a non-competitive N-methyl-D-aspartate (NMDA) antagonist that is used as an induction agent intravenously to maintain stable hemodynamics mainly due to the sympathomimetic effect. Administration of NMDA antagonist and opioid produce the synergistic or additive effect of analgesia.…”