Propofol increased the interleukin-6 to interleukin-10 ratio more than isoflurane after surgery in long-term alcoholic patients.
This study investigated the effect of an anaesthetic regimen on the immune response in 40 long-term alcoholic patients undergoing surgery. Patients were randomly allocated to receive either propofol or isoflurane during surgery. Plasma cytokines interleukin (IL)-6 and IL-10 were measured at defined times and rates of post-operative infections were documented. The IL-6/IL-10 ratio significantly increased with propofol compared with isoflurane on day 1 after surgery and the IL-10 level significantly increased with isoflurane on day 1 after surgery. The overall post-operative infection rate was significantly higher in isoflurane-treated patients. Our findings indicate that propofol anaesthesia might be the more favourable regimen, with the IL-6/IL-10 ratio indicating an attenuation of the immune imbalance after surgery in long-term alcoholic patients. These results support the undertaking of a properly powered clinical trial to determine if propofol anaesthesia can reduce the postoperative infection rate in this special patient population.
Von Dossow
V
V
Department of Anaesthesiology and Intensive Care Medicine, Charité University Medicine Berlin, Campus Mitte, Germany.
Baur
S
S
Sander
M
M
Tønnesen
H
H
Marks
C
C
Paschen
C
C
Berger
G
G
Spies
C D
CD
D000368:Aged; D000437:Alcoholism / Q000276:immunology*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D005260:Female; D041981:Gastrointestinal Tract / Q000601:surgery; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007239:Infections / Q000209:etiology; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D007530:Isoflurane / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011184:Postoperative Period; D015742:Propofol / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D018686:Anesthetics, Intravenous; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007530:Isoflurane; D006854:Hydrocortisone; D015742:Propofol