title: Effects of different preparations of propofol, diazepam, and etomidate on human neutrophils in vitro.
abstract: BACKGROUND
  Intravenous anaesthetics and sedatives can influence polymorphonuclear cell (PMN) functions. Some of the drugs for sedation and anaesthesia have been alternatively dissolved in lipid solutions containing medium (MCT) and/or long chain (LCT) triglycerides. The in vitro effects of two different diazepam (benzyl-alcohol, LCT/MCT), etomidate (propylene-glycol, LCT/MCT), and propofol (LCT, LCT/MCT) preparations on respiratory burst (RB) and phagocytosis of human PMNs were studied.
  
  
  METHODS
  Diazepam (2, 20 microg ml(-1)), etomidate (0.5, 5 microg ml(-1)), and propofol (6, 60 microg ml(-1)) were investigated in clinical and 10-fold concentrations with flow cytometric assays. The RB was measured with the fluorescent dye rhodamine after induction with Escherichia coli or formyl-methionyl-leucylphenylalanine (FMLP) following priming with tumour necrosis factor alpha (TNF-alpha). Phagocytosis of PMNs was carried out in whole blood after incubation with fluorescein-labelled E. coli.
  
  
  RESULTS
  LCT-propofol at 60 microg ml(-1) reduced the percentage of PMNs with RB activity after induction with E. coli (52.8+/-20.4) and TNF-alpha/FMLP (10.8+/-5.1)) as well as the percentage of phagocytosing PMNs (48.9+/-19.5) in contrast to LCT/MCT-propofol, which augmented all parameters (85.4+/-10.1, 50.3+/-12.7, 66.5+/-12.5). Also the higher concentrations of LCT/MCT-diluted etomidate and diazepam increased the percentage of RB positive PMNs compared to the alternative compositions. The percentage of phagocytosing PMNs was less reduced with 20 microg ml(-1) LCT/MCT-diazepam (85.2+/-6.9) than with the same concentration of benzyl-alcohol diluted diazepam (68.8+/-12.2) compared to the control.
  
  
  CONCLUSIONS
  The in vitro effects of diazepam, etomidate, and propofol are dependent on the solvent applied. The tested LCT/MCT preparations reduce the inhibitory effects on the bacterial killing capacity of PMNs found after incubation with propyleneglycol, benzyl-alcohol, or LCT preparations, respectively.
authors.affiliation: Department of Anaesthesiology, Hannover Medical School, Germany. heine.joern@mh-hannover.de
authors.forename: J
authors.initials: J
authors.lastname: Heine
authors.forename: K
authors.initials: K
authors.lastname: Jaeger
authors.forename: N
authors.initials: N
authors.lastname: Weingaertner
authors.forename: D
authors.initials: D
authors.lastname: Scheinichen
authors.forename: G
authors.initials: G
authors.lastname: Marx
authors.forename: S
authors.initials: S
authors.lastname: Piepenbrock
mesh_terms: D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D003975:Diazepam / Q000494:pharmacology*; D004912:Erythrocytes / Q000187:drug effects; D005045:Etomidate / Q000494:pharmacology*; D005434:Flow Cytometry; D006801:Humans; D066298:In Vitro Techniques; D009504:Neutrophils / Q000187:drug effects*; D010587:Phagocytosis / Q000187:drug effects; D015742:Propofol / Q000494:pharmacology*; D016897:Respiratory Burst / Q000187:drug effects; D014280:Triglycerides / Q000494:pharmacology
chemical_list: D018686:Anesthetics, Intravenous; D014280:Triglycerides; D003975:Diazepam; D015742:Propofol; D005045:Etomidate