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British Journal of Anaesthesia, 2000, Vol. 85, No. 3 424-430
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Anaesthesia with propofol decreases FMLP-induced neutrophil respiratory burst but not phagocytosis compared with isoflurane

J. Heine, K. Jaeger, A. Osthaus, N. Weingaertner, S. Münte, S. Piepenbrock and M. Leuwer

Department of Anaesthesiology, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany*

Propofol has been reported to produce a dose-dependent inhibition of phagocytosis and superoxide anion production during the respiratory burst (RB) of polymorphonuclear cells (PMNs) in vitro. In this randomized, blinded study, these two parameters were compared during propofol or isoflurane anaesthesia in patients undergoing elective interventional embolization of cerebral arterio-venous malformations. Anaesthesia was performed with continuous intravenous propofol 6–8 mg kg–1 h–1 (n=15) or isoflurane 0.8–1.0% end tidal (n=15). Heparinized blood was drawn before, and 2 and 4 h after induction of anaesthesia. The RB in isolated leucocytes was measured with the fluorescent dye rhodamine after ex vivo induction by Escherichia coli or tumour necrosis factor {alpha}/N-formyl-methionyl-leucylphenylalanine (TNF-{alpha}/FMLP). Phagocytosis was carried out in whole blood after incubation with fluorescein isothiocyanate (FITC)-labelled, opsonized E. coli and also measured with a flow cytometer. The two groups were similar in terms of biometric data and haemodynamic responsiveness. After 4 h of propofol or isoflurane anaesthesia, the mean (SD) phagocytosis of E. coli was 93.2% (7.0%) and 94.3% (9.2%), respectively, of that before anaesthesia. The percentage of PMN with RB activity following TNF-{alpha}/FMLP stimulation was significantly reduced after 2 h (80.9% (24.2%); P<0.05) and 4 h (53.7% (27.3); P<0.05) of anaesthesia with propofol compared with the values before induction. This effect of propofol anaesthesia was significantly different from the effect of isoflurane anaesthesia. In contrast to published in vitro results, 4 h of anaesthesia with propofol did not reduce the phagocytotic capacity of human blood PMN more than isoflurane anaesthesia.

Br J Anaesth 2000; 85: 424–30

* Corresponding author


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T. Nagata, M. Kansha, K. Irita, and S. Takahashi
Propofol inhibits FMLP-stimulated phosphorylation of p42 mitogen-activated protein kinase and chemotaxis in human neutrophils
Br. J. Anaesth., June 1, 2001; 86(6): 853 - 858.
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