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Inhibition of the neutrophil oxidative response by propofol: preserved in vivo function despite in vitro inhibition

Published online by Cambridge University Press:  19 June 2006

D. Fröhlich ,
B. Trabold ,
G. Rothe ,
K. Hoerauf  and
S. Wittmann
D. Fröhlich
Affiliation:
University of Regensburg, Department of Anaesthesiology, Regensburg, Germany
B. Trabold
Affiliation:
University of Regensburg, Department of Anaesthesiology, Regensburg, Germany
G. Rothe
Affiliation:
Bremer Zentrum für Laboratoriumsmedizin, Germany
K. Hoerauf
Affiliation:
University of Vienna, Department of Anaesthesiology, Vienna, Austria
S. Wittmann
Affiliation:
University of Regensburg, Department of Anaesthesiology, Regensburg, Germany
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Abstract

Summary

Background and objective: Propofol has been shown to inhibit a variety of functions of neutrophils in vitro, but there is a lack of in vivo data. To analyse the effects of propofol on neutrophil function in vivo we chose to investigate cataract surgery since it represents a small surgical procedure with minimal immunomodulatory effects induced by surgery. We sought to analyse any immunosuppressive effects of propofol after short-term administration in vivo in comparison to local anaesthesia as well as to in vitro effects of propofol. Methods: The study was designed as an open randomized trial enrolling 20 patients undergoing general or local anaesthesia. The neutrophil oxidative response and propofol plasma concentration were assessed prior, during and after anaesthesia. Neutrophil function was determined flow cytometrically based on dihydrorhodamine 123 oxidation. Results: Propofol concentrations which yielded a marked suppression in vitro did not alter the neutrophil oxidative response during cataract surgery in vivo. However, after local anaesthesia the neutrophil oxidative response declined to 37%, compared to the control response prior to anaesthesia. Conclusions: Although we could detect the well established suppression of neutrophil function by propofol in vitro it was not evident in vivo. This may be due to compensating effects on neutrophil function during surgery in vivo. The decline in the neutrophil oxidative response in the local anaesthesia group might be due to increased stress and catecholamine concentrations or a direct interaction of local anaesthetics with neutrophil intracellular signalling.

Keywords

ANAESTHETICS INTRAVENOUS, propofolNEUTROPHILS, function, oxidative responseANAESTHESIA, CONDUCTION, peribulbar block
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 11 , November 2006 , pp. 948 - 953
Copyright
2006 European Society of Anaesthesiology

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