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British Journal of Anaesthesia, 2003, Vol. 91, No. 6 805-809
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Low-dose remifentanil infusion does not impair natural killer cell function in healthy volunteers

A. J. Cronin*, N. M. Aucutt-Walter, T. Budinetz, C. P. Bonafide, N. A. DiVittore, V. Gordin, H. G. Schuler and R. H. Bonneau

Penn State College of Medicine, Milton S. Hershey Medical Center, 500 University Drive, H187, Hershey, PA 17033, USA

*Corresponding author. E-mail: acronin@psu.edu

Background. Mu opioid agonists suppress natural killer (NK) cell activity in animal models. Studies in human volunteers, however, have yielded conflicting results, with morphine suppressing and fentanyl increasing NK cell activity. This study evaluated the effect of a constant 8-h infusion of remifentanil on NK cell number and function in human volunteers.

Methods. After IRB approval and informed consent was obtained, 10 healthy volunteers underwent an 11 pm to 7 am infusion of saline, and at least 1 week later an infusion of 0.02–0.04 µg kg–1 min–1 remifentanil. Blood was collected at 7 am for measurement of NK cell cytotoxicity using a 51Cr release assay and measurement of NK cell number using fluorescent flow cytometry.

Results. Median and range of the total NK cell cytoxicity (KU ml–1) was 745.0 (498.3–1483.6) on the control morning and 818.6 (238.5–1454.5) on the morning following the remifentanil infusion. Neither the number of NK cells ml–1 (2.5x105 (1.4x105–4.2x105) vs 2.7x105 (1.1x105–4.4x105)) nor the cytotoxicity per 1000 NK cells (KU 1000 NK cells–1) (3.0 (1.8–5.2) vs 2.9 (0.9–6.7)) changed between the control and remifentanil conditions.

Conclusions. An 8-h infusion of remifentanil did not affect NK cell activity in normal volunteers. This result differs from previous findings of morphine-induced NK cell activity suppression and fentanyl-induced NK cell activity enhancement in normal volunteers.

Br J Anaesth 2003; 91: 805–9


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