Effect of propofol and isoflurane anaesthesia on the immune response to surgery.
There are two major subpopulations of peripheral helper T lymphocytes: T helper 1 (Th1) and T helper 2 (Th2) cells. Surgical stress increases the number of Th2 cells, and decreases that of Th1 cells, resulting in a decrease in the Th1/Th2 ratio, and, consequently, in suppressed cell-mediated immunity. Since anaesthesia can suppress the stress response to surgery, it may inhibit the decrease in the Th1/Th2 ratio. Using flow cytometry, we studied whether propofol anaesthesia (n = 9) or isoflurane anaesthesia (n = 9) had more effect on the decrease in the Th1/Th2 ratio after surgery in patients undergoing craniotomy. The Th1/Th2 ratio decreased significantly after isoflurane anaesthesia (p = 0.011), while it did not change after propofol anaesthesia. The ratio was significantly lower with isoflurane than propofol (p = 0.009). Propofol anaesthesia attenuated the surgical stress-induced adverse immune response better than isoflurane anaesthesia.
Inada
T
T
Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka, 570-8507, Japan. takefumi@wd5.so-net.ne.jp
Yamanouchi
Y
Y
Jomura
S
S
Sakamoto
S
S
Takahashi
M
M
Kambara
T
T
Shingu
K
K
D000328:Adult; D000368:Aged; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D003399:Craniotomy; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D007530:Isoflurane / Q000494:pharmacology; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D015742:Propofol / Q000494:pharmacology; D018417:Th1 Cells / Q000187:drug effects*; D018418:Th2 Cells / Q000187:drug effects*
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D007530:Isoflurane; D015742:Propofol