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Study evaluates the effect of anesthesia on the inflammatory reaction after surgery

Qequipe Unesp investigated the effect of two commonly used inhaled anesthetics, isoflurane and servoflurano

 
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Research conducted at Universidade Estadual Paulista (UNESP) investigated the effect of two commonly used inhaled anesthetics isoflurane and servoflurano the inflammatory reaction triggered in the body after surgery.

The investigation was conducted in rats subjected to a procedure for the removal of a kidney and revealed that the drug isoflurane caused a greater release of inflammatory substances evaluated.

When we have surgery, the body realizes that he is suffering an assault calls and releases inflammatory cytokines. They activate blood clotting and help prevent bleeding, Pinheiro said Norma Sue Modolo, coordinator of research funded by FAPESP.

Modolo said, this reaction is expected but can not be overstated because of the risk of thrombosis. We are trying to find an anesthetic that can modulate the inflammatory response. It can not be canceled because the patient would suffer bleeding. But it can not be much exacerbated by the drug. This is especially important in high-risk patients, such as heart disease, he said.

To compare the effect of the two substances, 16 animals were divided into two groups. Half received isoflurane and others, servoflurano. Blood samples were collected from the tail four occasions: before application of the anesthetic (M0), one hour after anesthesia (M1), a half hour after surgery (M3) and 24 hours after surgery (M4).

We measured five different inflammatory cytokines: tumor necrosis factor alpha (TNF-á), interferon gamma (IFN-ã) and interleukin 12, 6:10. With the exception of interleukin 10, which has anti-inflammatory action, the others are all pro-inflammatory, Modolo said.

Test results showed that the drugs caused significant changes only in the release of TNF-a and especially in the group receiving the drug isoflurane.

TNF-á is the first cytokine released after an injury and has the mission to activate the inflammatory cascade in the body called. In a situation of trauma or infection, it induces fever, activates coagulation, cause vasodilation and may lead to hypoglycemia, Modolo said.

In the group of isoflurane concentration of TNF-á blood increased from 0 nanograms per milliliter (ng / ml) in M1 to 10.54 ng / ml in M3, ie, shortly after surgery. In the analysis the day after the dosing had dropped to 4.55 ng / ml.

In the sevoflurane group, the TNF-á went from 0 ng / ml in M1 to 4.43 ng / ml in M3. The next day, the dosage had fallen to 1.76 ng / ml. It could be observed that the anesthetic altered the inflammatory response, but not so exaggerated. The situation was returning to normal the next day, Modolo evaluated.

The researcher points out, however, that research was done in healthy animals. I imagine that a healthy patient undergoing a relatively simple surgery would have no problems with any of the two anesthetics. But in obese people who already have more inflammatory substances in the body, or heart disease, lung disease and newborns, perhaps these anesthetics can cause an inflammatory response exacerbated, he said.

The team intends to follow this line of research, first assessing the effect of drugs in rats with health problems and in the future, in humans. We also want to investigate the action of other anesthetics, including intravenous, Modolo said.

Source: FAPESP
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inflammatory reaction after surgery    inflammation    soflurano    servoflurano    UNESP    Norma Sueli Pinheiro Modolo   
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