Immune Function following Major Spinal Surgery and General Anesthesia.
anesthesia
cytokine
immune suppression
immunity
spinal fusion
trauma
Journal
Journal of pediatric intensive care
ISSN: 2146-4618
Titre abrégé: J Pediatr Intensive Care
Pays: Germany
ID NLM: 101592756
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
13
05
2020
accepted:
06
08
2020
entrez:
8
11
2021
pubmed:
11
9
2020
medline:
11
9
2020
Statut:
epublish
Résumé
There are reported differences in the effects that general anesthetics may have on immune function after minor surgery. To date, there are no prospective trials comparing total intravenous anesthesia (TIVA) with a volatile agent-based technique and its effects on immune function after major spinal surgery in adolescents. Twenty-six adolescents undergoing spinal fusion were randomized to receive TIVA with propofol-remifentanil or a volatile agent-based technique with desflurane-remifentanil. Immune function measures were based on the antigen-presenting and cytokine production capacity, and relative proportions of cell populations. Overall characteristics of the two groups did not differ in terms of perioperative times, hemodynamics, or fluid shifts, but those treated with propofol had lower bispectral index values. Experimental groups had relatively high baseline interleukin-10 values, but both showed a significant inflammatory response with similar changes in their respective immune functions. This included a shift toward a granulocytic predominance; a transient reduction in monocyte markers with significant decrease in antigen-presenting capacity and cytokine production capacity. Anesthetic choice does not appear to differentially impact immune function, but exposure to anesthetics and surgical trauma results in reproducibly measurable suppression of both innate and adaptive immunity in adolescents undergoing posterior spinal fusion. The magnitude of this suppression was modest when compared with pediatric and adult patients with critical illnesses. This study highlighted the need to evaluate immune function in a broader population of surgical patients with higher severity of illness.
Identifiants
pubmed: 34745697
doi: 10.1055/s-0040-1716668
pii: 2000080
pmc: PMC8561792
doi:
Types de publication
Journal Article
Langues
eng
Pagination
248-255Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of Interest None declared.
Références
Br J Anaesth. 2001 Jun;86(6):853-8
pubmed: 11573595
Br J Anaesth. 1993 Jan;70(1):99-100
pubmed: 8431346
Eur J Anaesthesiol. 1986 Jul;3(4):321-30
pubmed: 3021444
Autoimmun Rev. 2012 May;11(6-7):A486-92
pubmed: 22155200
Br J Surg. 1993 Feb;80(2):205-9
pubmed: 8443652
Intensive Care Med. 2011 Mar;37(3):525-32
pubmed: 21153402
Acta Anaesthesiol Scand. 1999 Jan;43(1):71-6
pubmed: 9926192
Intensive Care Med. 2004 Jan;30(1):96-102
pubmed: 14605804
Br J Anaesth. 1992 Jul;69(1):70-4
pubmed: 1637607
Am J Surg. 1999 Jan;177(1):55-60
pubmed: 10037309
Crit Care Med. 2013 Jan;41(1):224-36
pubmed: 23222256
Anaesthesia. 1997 Sep;52(9):921-3
pubmed: 9349088
Acta Anaesthesiol Scand. 1992 Apr;36(3):201-20
pubmed: 1574967
Br J Anaesth. 1997 Jun;78(6):718-23
pubmed: 9215026
Am J Respir Crit Care Med. 2018 Aug 1;198(3):361-369
pubmed: 29470918
J Immunol. 2001 Jun 1;166(11):6952-63
pubmed: 11359857
Crit Care Med. 2006 Oct;34(10):2658-65
pubmed: 16932228
Anesthesiology. 1998 Nov;89(5):1218-27
pubmed: 9822011
Intensive Care Med. 2006 Aug;32(8):1175-83
pubmed: 16741700
Surg Today. 2010 Sep;40(9):793-808
pubmed: 20740341
Anesthesiology. 2003 Jan;98(1):74-81
pubmed: 12502982
Intensive Care Med. 1993;19(5):299-302
pubmed: 8408941
J Clin Anesth. 2013 Jun;25(4):255-62
pubmed: 23659826
Am J Gastroenterol. 2006 May;101(5):1117-24
pubmed: 16606350
Acta Anaesthesiol Scand. 1994 Nov;38(8):858-62
pubmed: 7887111
Arch Surg. 1986 Sep;121(9):1000-5
pubmed: 3741094
Anaesthesia. 1995 Dec;50(12):1056-61
pubmed: 8546287
Clin Sci (Lond). 1990 Aug;79(2):161-5
pubmed: 2167805
J Thorac Cardiovasc Surg. 2012 May;143(5):1160-1166.e1
pubmed: 21996297
Anaesthesia. 1996 May;51(5):465-73
pubmed: 8694161
Clin Pediatr (Phila). 2003 Apr;42(3):227-34
pubmed: 12739921
Anesthesiology. 1981 Dec;55(6):650-4
pubmed: 7030150
Anesthesiology. 1986 Jan;64(1):4-12
pubmed: 3002210
J Clin Anesth. 2005 Nov;17(7):517-27
pubmed: 16297751
Crit Care. 2014 Jul 08;18(4):R145
pubmed: 25005517
J Child Orthop. 2013 Feb;7(1):3-9
pubmed: 24432052
Int J Immunopharmacol. 1995 Jun;17(6):529-34
pubmed: 7499031
Intensive Care Med. 1996 Oct;22 Suppl 4:S474-81
pubmed: 8923092
J Surg Res. 2018 Aug;228:221-227
pubmed: 29907215
Crit Care Med. 1999 Feb;27(2):313-8
pubmed: 10075055
Eur J Anaesthesiol. 1996 Nov;13(6):582-8
pubmed: 8958489
Anaesth Intensive Care. 1999 Dec;27(6):623-7
pubmed: 10631417
Anaesthesist. 2001 Jul;50(7):494-9
pubmed: 11496686
JAMA. 2011 Dec 21;306(23):2594-605
pubmed: 22187279
Surg Infect (Larchmt). 2003 Summer;4(2):171-80
pubmed: 12906717
Am J Respir Crit Care Med. 2015 Feb 1;191(3):309-15
pubmed: 25489881
Crit Care Med. 2002 May;30(5):1140-5
pubmed: 12006816
Anesth Analg. 1998 Sep;87(3):695-700
pubmed: 9728856
Anesthesiology. 1999 Jul;91(1):187-97
pubmed: 10422944
J Clin Lab Immunol. 1983 May;11(1):21-6
pubmed: 6876140
Clin Transl Immunology. 2016 Apr 29;5(4):e77
pubmed: 27195120
Immunopharmacol Immunotoxicol. 1996 May;18(2):323-36
pubmed: 8771374
J Immunol. 2005 Mar 15;174(6):3765-72
pubmed: 15749917
Acta Anaesthesiol Scand. 1996 Feb;40(2):141-2
pubmed: 8848909
J Immunol Methods. 1986 Apr 17;88(2):277-83
pubmed: 2420901
Shock. 2014 Oct;42(4):313-21
pubmed: 24978895
Eur J Anaesthesiol. 1996 Sep;13(5):471-3
pubmed: 8889420
Shock. 1996;6 Suppl 1:S6-9
pubmed: 8828091
J Intensive Care Med. 2019 Jun;34(6):486-494
pubmed: 28372498
Anaesthesia. 1997 Apr;52(4):341-4
pubmed: 9135186
Chem Immunol. 2000;74:162-77
pubmed: 10608087