Effect of Propofol and Desflurane on Immune Cell Populations in Breast Cancer Patients: A Randomized Trial
Journal of Korean Medical Science 2015³â 30±Ç 10È£ p.1503 ~ p.1508
¿ìÀçÈñ(Woo Jae-Hee) - Ewha Womans University School of Medicine Department of Anesthesiology and Pain Medicine
¹éÈñÁ¤(Baik Hee-Jung) - Ewha Womans University School of Medicine Department of Anesthesiology and Pain Medicine
±èÁöÈ¿(Kim Chi-Hyo) - Ewha Womans University School of Medicine Department of Anesthesiology and Pain Medicine
Á¤¶ô°æ(Chung Rack-Kyung) - Ewha Womans University School of Medicine Department of Anesthesiology and Pain Medicine
±èµ¿¿¬(Kim Dong-Yeon) - Ewha Womans University School of Medicine Department of Anesthesiology and Pain Medicine
À̱Ϳë(Lee Guie-Yong) - Ewha Womans University School of Medicine Department of Anesthesiology and Pain Medicine
õÀºÈñ(Chun Eun-Hee) - Ewha Womans University School of Medicine Department of Anesthesiology and Pain Medicine
Abstract
Several factors can affect the perioperative immune function. We evaluated the effect of propofol and desflurane anesthesia on the surgery-induced immune perturbation in patients undergoing breast cancer surgery. The patients were randomly assigned to receive propofol (n = 20) or desflurane (n = 20) anesthesia. The total and differential white blood cell counts were determined with lymphocyte subpopulations before and 1 hr after anesthesia induction and at 24 hr postoperatively. Plasma concentrations of interleukin (IL)-2 and IL-4 were also measured. Both propofol and desflurane anesthesia preserved the IL-2/IL-4 and CD4+/CD8+ T cell ratio. Leukocytes were lower in the propofol group than in the desflurane group at 1 hr after induction (median [quartiles], 4.98 [3.87-6.31] vs. 5.84 [5.18-7.94] 103/¥ìL) and 24 hr postoperatively (6.92 [5.54-6.86] vs. 7.62 [6.22-9.21] 103/¥ìL). NK cells significantly decreased 1 hr after induction in the propofol group (0.41 [0.34-0.53] to 0.25 [0.21-0.33] 103/¥ìL), but not in the desflurane group (0.33 [0.29-0.48] to 0.38 [0.30-0.56] 103/¥ìL). Our findings indicate that both propofol and desflurane anesthesia for breast cancer surgery induce a favorable immune response in terms of preservation of IL-2/IL-4 and CD4+/CD8+ T cell ratio in the perioperative period. With respect to leukocytes and NK cells, desflurane anesthesia is associated with less adverse immune responses than propofol anesthesia during surgery for breast cancer. (Clinical trial registration at https://cris.nih.go.kr/cris number: KCT0000939)
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Propofol, Desflurane, Immune System, Breast Neoplasms
KMID :
0191120150300101503
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À¯È¿¼º°á°ú(Recomendation)
With respect to leukocytes and NK cells, desflurane anesthesia is associated with less adverse immune responses than propofol anesthesia during surgery for breast cancer; NK cells significantly decreased 1 hr after induction in the propofol group (0.41 [0.34-0.53] to 0.25 [0.21-0.33] 103/¥ìL), but not in the desflurane group (0.33 [0.29-0.48] to 0.38 [0.30-0.56] 103/¥ìL)