Abstract
Polymorphonuclear leukocytes (PMNL)play a vital role in the defence against invading bacteria. It is known that some anaesthetics inhibit PMNL function and, thus, possibly enhance perioperative infection. We investigated the effect of methohexitone, flunitrazepam, and droperidol on three bactericidal PMNL functions, i.e., Superoxide anion production, hydrogen peroxide generation, and activity of released myeloperoxidase, in vitro. Approved photometrical assays were used. Superoxide anion was measured by the reduction of cytochrome C, hydrogen peroxide by the horse radish peroxidase catalysed oxidation of phenol red, and myeloperoxidase by the turnover of 2,2’-azino-di(3-ethylbenzthiazoline) sulfonic acid. Methohexitone’ (P ≤ 0.001) and flunitrazepam (P ≤ 0.01) inhibited superoxide anion production, and methohexitone (P ≤ 0.01) reduced hydrogen peroxide generation but only at concentrations beyond clinical relevance. Droperidol did not cause any alteration of the PMNL functions tested. Consequently, it seems unlikely that the usual doses of methohexitone, flunitrazepam, or droperidol promote bacterial infections in vivo by impairing the activity of myeloperoxidase or by inhibiting the generation of Superoxide anion or hydrogen peroxide.
Résumé
Les leucocytes polynucléaires jouent un rôle essentiel de défense contre l’invasion bactérienne. On sait que certains anesthésiques inhibent cette fonction et ainsi pourraient favoriser l’infection périopératoire. Nous avons recherché in vitro les effets du méthohéxitone, du flunitrazépam et du dropéridol sur trois fonctions des polynucléaires, i.e. la production de l’anion superoxyde, la génération du peroxyde d’hydrogène et l’activité de la myéloperoxydase. Des épreuves photométriques reconnues ont été utilisées. L’anion superoxyde a été mesuré par la réduction du cytochrome C, le peroxyde d’hydrogène par l’oxydation catalytique du rouge phénol par la peroxydase du raifort et la myéloperoxydase par la production de l’acide sulfonique 2,2’azino-di (3-éthylbenzthiazoline). Le méthohexitone (P ≤ 0,001) et le flunitrazépam (P ≤ 0,01) inhibent la production de l’anion superoxyde, et le méthohexitone diminue la génération du peroxyde d’hydrogène mais seulement à des concentrations qui dépassent l’usage clinique. Le dropéridol ne cause pas d’altérations des fonctions polynucléaires. Par conséquent, selon toute probabilité, les doses usuelles de méthohexitone, de flunitrazépam ou de dropéridol ne favorisent pas l’infection bactérienne in vivo par altération de l’activité de la myéloperoxydase ou par l’inhibition de la génération de l’anion superoxyde ou du peroxyde d’hydrogène.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Graham EA. The influence of ether and ether anesthesia on bacteriolysis, agglutination, and phagocytosis. J Infect Dis 1911; 8: 147–75.
Stevenson GW, Hall SC, Rudnick S, Seleny FL, Stevenson HC. The effect of anesthetic agents on the human immune response. Anesthesiology 1990; 72: 542–52.
Kress HG, Eberlein T. Wirkung von Anästhesie und Operation auf wesentliche Immunfunktionen. Anästhesiologie Intensivmedizin Notfallmedizin Schmerztherapie 1992; 27: 393–402.
Hjorth R, Jonsson AK, Vretblad P. A rapid method for purification of human granulocytes using Percoll. A comparison with dextran sedimentation. J Immunol Methods 1981; 43: 95–101.
Gitter A, Heilmeyer L, Brüschke G. (Eds.). Taschenbuch Klinischer Funktionsprüfungen. 10th ed. Stuttgart: Gustav Fischer Verlag, 1978; 285–6.
Stangel W, Seidel J, Mirkani J, Behrmann M, Hülsheger H. Granulozytenfunktionen in gelagerten Blutkonserven. Beitr Infusionther 1986; 15: 231–52.
Weening RS, Wever R, Roos D. Quantitative aspects of the production of Superoxide radicals by phagocytizing human granulocytes. J Lab Clin Med 1975; 85: 245–52.
Rick W. Klinische Chemie und Mikroskopie. 5th ed. Berlin: Springer-Verlag, 1977; 155–68.
Pick E, Keisari Y. A simple colorimetric method for the measurement of hydrogen peroxide produced by cells in culture. J Immunol Methods 1980; 38: 161–70.
Schmitt M, Keller HU, Cottier H. Qualitative and quantitative assessment of human polymophonuclear leukocyte (PMNL) functions. Beitr Infusionther 1986; 15: 196–230.
Sunshine I, Whitwam JG, Fike WW, Finkle B, LeBeau J. Distribution and excretion of methohexitone in man. Br J Anaesth 1966; 38: 23–8.
Lauven PM, Stoeckel H, Schwilden H, Schüttler J. Klinische Pharmakokinetik von Midazolam, Flunitrazepam und Diazepam. Anästhesie Intensivtherapie Notfallmedizin 1981; 16: 135–42.
Fischler M, Bonnet F, Trang H, et al. The pharmacokinetics of droperidol in anesthetized patients. Anesthesiology 1986; 64: 486–9.
Smolen JE, Boxer LA. Functions of neutrophils.In Williams WJ, Beutler E, Erslev AJ, Lichtman MA (Eds.). Hematology, 4th ed., New York: McGraw-Hill Publishing Company, 1990; 780–94.
Broide DH. Inflammatory cells: structure and function.In: Stites DP, Terr A (Eds.). Basic and Clinical Immunology, 7th ed., London: Prentice-Hall International Inc., 1991: 141–5.
Klebanoff SJ. Phagocytic cells: products of oxygen metabolism.In: Gallin JI, Goldstein IM, Snyderman R (Eds.). Inflammation. Basic Principles and Clinical Correlates, New York: Raven Press, 1988; 391–444.
White IWC, Gelb AW, Wexler HR, Stiller CR, Keown PA. The effects of intravenous anaesthetic agents on human neulrophil chemiluminescence. Can Anaesth Soc J 1983; 30: 506–11.
Kress HG, Eberlein T, Hörber B, Weis KH. Suppression of neutrophil migration and chemiluminescence is due to the sulphur atom in the thiobarbiturate molecule. Acta Anaesthesiol Scand 1989; 33: 122–8.
Krumholz W, Kebeiks B, Bachmann-Mennenga B. Veränderung der Granulozyten-Vollblut-Chemilumineszenz durch Thiopental, Methohexital und das Lösungsmittel Natriumkarbonat. Anaesthesist (Supplement 1) 1989; 38: 133.
Krumholz W, Jorgall H, Käbisch S, Hempelmann G. Narkoseeinleitungsmittel und Granulozytenadhärenz. Anästhesie Intensivtherapie Notfallmedizin 1988; 23: 69–72.
Moudgil GC, Allan RB, Russell RJ, Wilkinson PC. Inhibition, by anaesthetic agents, of human leucocyte locomotion towards chemical attractants. Br J Anaesth 1977; 49: 97–105.
Kress HG, Segmüller R. Intravenöse Anaesthetika und Motilität humaner neutrophiler Granulozyten in vitro. Anaesthesist 1987; 36: 356–61.
Goldfarb G, Belghiti J, Gautero H, Boivin P.In vitro effect of benzodiazepines on polymorphonuclear leukocyte oxidative activity. Anesthesiology 1984; 60: 57–60.
Kress HG, Weiler R. Benzodiazepine und Chemilumineszenz neutrophiler Granulozyten in vitro: Vergleich mit dem Antagonisten Flumazenil. Anaesthesist (Supplement). 1989; 38: 295.
Nakagawara M, Hirokata Y, Yoshitake J. Effects of anesthetics on Superoxide releasing activity of human polymorphonuclear leukocytes. Masui 1985; 34: 754–9.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Krumholz, W., Demel, C., Jung, S. et al. The influence of intravenous anaesthetics on polymorphonuclear leukocyte function. Can J Anaesth 40, 770–774 (1993). https://doi.org/10.1007/BF03009774
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03009774