Anesthetics, immune cells, and immune responses

Shin Kurosawa, Masato Kato

    Research output: Contribution to journalArticlepeer-review

    229 Citations (Scopus)

    Abstract

    General anesthesia accompanied by surgical stress is considered to suppress immunity, presumably by directly affecting the immune system or activating the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. Along with stress such as surgery, blood transfusion, hypothermia, hyperglycemia, and postoperative pain, anesthetics per se are associated with suppressed immunity during perioperative periods because every anesthetic has direct suppressive effects on cellular and neurohumoral immunity through influencing the functions of immunocompetent cells and inflammatory mediator gene expression and secretion. Particularly in cancer patients, immunosuppression attributable to anesthetics, such as the dysfunction of natural killer cells and lymphocytes, may accelerate the growth and metastases of residual malignant cells, thereby worsening prognoses. Alternatively, the anti-inflammatory effects of anesthetics may be beneficial in distinct situations involving ischemia and reperfusion injury or the systemic inflammatory response syndrome (SIRS). Clinical anesthesiologists should select anesthetics and choose anesthetic methods with careful consideration of the clinical situation and the immune status of critically ill patients, in regard to long-term mortality, morbidity, and the optimal prognosis.

    Original languageEnglish
    Pages (from-to)263-277
    Number of pages15
    JournalJournal of Anesthesia
    Volume22
    Issue number3
    DOIs
    Publication statusPublished - 2008

    Keywords

    • Anesthetics
    • Hypothalamic-pituitary-adrenalaxis
    • Immune cells
    • Immuno suppression
    • Prognosis

    ASJC Scopus subject areas

    • Anesthesiology and Pain Medicine

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