Effect of propofol and isoflurane anaesthesia on the immune response to surgery

• Published in: Anaesthesia Vol. 59; no. 10; pp. 954 - 959
• Main Authors: Inada, T., Yamanouchi, Y., Jomura, S., Sakamoto, S., Takahashi, M., Kambara, T., Shingu, K.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.10.2004; Blackwell; Blackwell Publishing Ltd
• Subjects: Adult; Aged; Anaesthetics; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Inhalation - pharmacology; Anesthetics, Intravenous - pharmacology; Biological and medical sciences; Cellular immunity; Comparative analysis; Craniotomy; Effects; Female; Humans; Immune system; Immunity, Cellular - drug effects; isoflurane; Isoflurane - pharmacology; Lymphocyte Count; Male; Medical sciences; Middle Aged; Postoperative Period; propofol; Propofol - pharmacology; Stress; Th1; Th1 Cells - drug effects; Th2; Th2 Cells - drug effects; T‐lymphocytes; Immune response; Surgery; Anaesthetics; propofol; isoflurane. Cellular immunity. T-lymphocytes; Th1; T-Lymphocyte; Anesthesia; Cellular immunity; Propofol; Isoflurane; Th2
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/j.1365-2044.2004.03837.x

Summary There are two major subpopulations of peripheral helper T lymphocytes: T helper 1 (Th1) and T helper 2 (Th2) cells. Surgical stress increases the number of Th2 cells, and decreases that of Th1 cells, resulting in a decrease in the Th1/Th2 ratio, and, consequently, in suppressed cell‐mediated immunity. Since anaesthesia can suppress the stress response to surgery, it may inhibit the decrease in the Th1/Th2 ratio. Using flow cytometry, we studied whether propofol anaesthesia (n = 9) or isoflurane anaesthesia (n = 9) had more effect on the decrease in the Th1/Th2 ratio after surgery in patients undergoing craniotomy. The Th1/Th2 ratio decreased significantly after isoflurane anaesthesia (p = 0.011), while it did not change after propofol anaesthesia. The ratio was significantly lower with isoflurane than propofol (p = 0.009). Propofol anaesthesia attenuated the surgical stress‐induced adverse immune response better than isoflurane anaesthesia.