Effect of general and regional anesthesia on some neutrophil functions. 1998

J Ciepichał, and A Kübler
Department of Anesthesiology and Intensive Therapy, University Medical School, Wrocław, Poland.

Transient immunosuppression in patients during anesthesia and surgery may cause postoperative infections. In the immunity against pathogens the processes of non-specific defence are of special importance and engage neutrophils as the major cell type. The aim of this study was to monitor activity of neutrophils during and after surgery, applying different methods of anesthesia. The status of neutrophils was determined by evaluation of chemotactic, phagocytic and chemiluminescence (bactericidal) activities. The study included 78 patients, who underwent surgery due to pathological injury-effected changes or due to varicose veins of extremities. Blood samples for determination of the neutrophil activity were taken just before anesthesia, when the symptoms of anesthesia occurred, 15 min after starting of surgery, 24 h and 5-7 day after surgery. In majority of patients we observed neutrophilic leukocytosis. There was a statistically significant correlation between leukocytosis and percentage of neutrophils in the subsequent days after surgery, depending on a kind and extension of surgical intervention. In addition, we have found a decrease in chemotactic, phagocytic and bactericidal activity after all kinds of anesthesia. The decrease in the phagocytic activity lasted longer, usually at least 24 h after surgery, whereas chemotaxis and chemiluminescence returned quickly to control levels. In the spinal anesthesia the chemiluminescence was not altered; this phenomenon could result from blockade of the sympathetic nerve system and activation of neutrophils metabolism. The brachial plexus blockade had the statistically smallest effect on the function of neutrophils. In the long-term anesthesia (longer than 2 h), particularly using halothane, we have observed depressed values of chemotaxis, phagocytosis and chemiluminescence which lasted longer than in other studied group of patients. We conclude that monitoring of the neutrophil functions is a useful form of studying immune reactions of patients to anesthesia and surgery.

UI MeSH Term Description Entries
D008297 Male Males
D009504 Neutrophils Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. LE Cells,Leukocytes, Polymorphonuclear,Polymorphonuclear Leukocytes,Polymorphonuclear Neutrophils,Neutrophil Band Cells,Band Cell, Neutrophil,Cell, LE,LE Cell,Leukocyte, Polymorphonuclear,Neutrophil,Neutrophil Band Cell,Neutrophil, Polymorphonuclear,Polymorphonuclear Leukocyte,Polymorphonuclear Neutrophil
D010587 Phagocytosis The engulfing and degradation of microorganisms; other cells that are dead, dying, or pathogenic; and foreign particles by phagocytic cells (PHAGOCYTES). Phagocytoses
D001917 Brachial Plexus The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. Plexus, Brachial
D002634 Chemotaxis, Leukocyte The movement of leukocytes in response to a chemical concentration gradient or to products formed in an immunologic reaction. Leukotaxis,Leukocyte Chemotaxis
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000765 Anesthesia, Conduction Injection of an anesthetic to inhibit nerve transmission in a specific part of the body. Anesthesia, Regional,Conduction Anesthesia,Regional Anesthesia
D000768 Anesthesia, General Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery. Anesthesias, General,General Anesthesia,General Anesthesias
D000775 Anesthesia, Spinal Procedure in which an anesthetic is injected directly into the spinal cord. Anesthesias, Spinal,Spinal Anesthesia,Spinal Anesthesias

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