General versus regional anaesthesia for cataract surgery: effects on neutrophil apoptosis and the postoperative pro-inflammatory state.
At clinically relevant concentrations, volatile anaesthetic agents influence neutrophil function. Our hypothesis was that sevoflurane would inhibit neutrophil apoptosis and consequently influence the postoperative pro-inflammatory state. In order to identify selectively the effect of the anaesthetic agent sevoflurane, we studied patients undergoing minimally stimulating (cataract) surgery randomly allocated to receive either sevoflurane (n = 11) or local anaesthesia (n = 12). Venous blood samples were taken immediately prior to anaesthesia and at 1, 8 and 24 h thereafter. The rate of neutrophil apoptosis, plasma concentration of cytokines and differential white cell count were measured. The rates of neutrophil apoptosis and plasma concentrations of IL-1beta, TNF-alpha and IL-8 at each time point were similar in the two groups. IL-6 concentrations increased significantly and to a similar extent compared to preanaesthetic levels at 8 and 24 h. This study demonstrates that sevoflurane does not influence the rate of neutrophil apoptosis, cytokine concentrations and neutrophil count following cataract surgery.
Goto
Y
Y
Department of Anaesthesia and Intensive Care Medicine, Department of Ophthalmology, and Department of Surgery, Cork University Hospital, University College Cork, Ireland.
Ho
S L
SL
McAdoo
J
J
Fanning
N F
NF
Wang
J
J
Redmond
H P
HP
Shorten
G D
GD
D000368:Aged; D000704:Analysis of Variance; D000769:Anesthesia, Inhalation; D000772:Anesthesia, Local; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D017209:Apoptosis / Q000187:drug effects*; D002045:Bupivacaine / Q000008:administration & dosage; D002387:Cataract Extraction; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000276:immunology; D018836:Inflammation Mediators / Q000097:blood*; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D019060:Minimally Invasive Surgical Procedures; D009407:Nerve Block; D009504:Neutrophils / Q000187:drug effects*; D000077149:Sevoflurane; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D018685:Anesthetics, Inhalation; D000779:Anesthetics, Local; D018836:Inflammation Mediators; D007375:Interleukin-1; D015850:Interleukin-6; D008738:Methyl Ethers; D014409:Tumor Necrosis Factor-alpha; D000077149:Sevoflurane; D008012:Lidocaine; D002045:Bupivacaine