Abstract
General anaesthesia accompanied by surgical stress may influence the inflammatory responses that are essential for maintaining the homeostatic state during the postoperative course. Severe dysregulation of the inflammatory process may provoke or aggravate postoperative complications, e.g. increased susceptibility to infections, inadequate stress reactions and hypercatabolism. Anaesthetics have been suspected of impairing various functions of the immune system either directly, by disturbing the functions of immune-competent cells, or indirectly by modulating the stress response. In the past, conflicting data on the possible immunological side effects of anaesthetics have been published. Potential reasons for these controversial findings include heterogeneous patient study groups with diverse pre-existing diseases, lack of standardisation of surgical procedures, major differences in the length and severity of surgical tissue injury and a small number of randomised studies. Although the immunological effects are of minor consequence in subjects with normal immune functions, the suppression of cellular and humoral immunity following surgery and general anaesthesia may be relevant in patients with pre-existing immune disorders.
Section snippets
Effects of several anaesthetics used in general anaesthesia— in vitro studies. With regard to the various potential effects related to surgical stress and/or other variables influencing the immunomodulatory properties of anaesthetics in vivo, many investigators have assayed these effects in a controlled in vitro research environment. The increasing knowledge of recent years is strongly related to the development in basic sciences and to the improvement in laboratory techniques, e.g. in cell separation and cell culture methods. It has been demonstrated that anaesthetics at
General anaesthesia and inflammation—invivo studies
In contrast to the well-documented immunomodulatory effects of the different anaesthetic agents used in general anaesthesia, in vitro reports based on in vivo studies have suggested only transient direct effects on the immune response (Table 2).
The anaesthetics used in general anaesthesia may modulate the inflammatory response by either acting on immune cells or, in association with preferred anaesthesiology techniques, by affecting the stress response.
Inflammation incorporates a complex of Summary
Surgical interventions and general anaesthesia initiate inflammatory responses that are essential for maintaining homeostatic regulation. Severe dysregulation of the inflammatory process may induce postoperative complications. The assessment of the potential effects of different anaesthetics is difficult, since different factors may affect the perioperative balance between the pro- and anti-inflammatory mechanisms. Conflicting data have been published on anaesthetics. The various explanations
Source: sciencedirect.com
Saturday, May 2, 2026
