Gene and systemic inflammatory effects and neuroendocrine response in surgical patients anesthetized with desflurane-nitrous oxide or desflurane-nitrous oxide-free: A randomized trial

Nenhuma Miniatura disponível

Data

2021-01-01

Autores

Arruda, Nayara M. [UNESP]
Braz, Leandro G. [UNESP]
Nogueira, Flávia R. [UNESP]
Souza, Kátina M. [UNESP]
Aun, Aline G. [UNESP]
de Carvalho, Lídia R. [UNESP]
Braz, José Reinaldo C. [UNESP]
Braz, Mariana G. [UNESP]

Título da Revista

ISSN da Revista

Título de Volume

Editor

Resumo

There is growing interest in assessing possible immunotoxicological effects in anesthetized patients. There are controversial findings concerning the effect of nitrous oxide (N2O) anesthetic gas effect on inflammatory response. We tested the hypothesis that N2O associated with desflurane (inhalational anesthetic) was likely to worsen neuro-immune-endocrine effects when compared with desflurane alone in this randomized trial. The primary endpoint of this study was to evaluate the systemic proinflammatory interleukin (IL)-6, and the secondary endpoints included other systemic (IL-1β, TNF-α, IL-8, IL-10, IL-17A and high-sensitivity C-reactive protein – hs-CRP) and genetic inflammatory markers (NF-kB, IL-6 and COX-2) as well as hormones (adrenocorticotropic hormone, cortisol and prolactin) comparing patients undergoing minor surgery with or without N2O-desflurane. As a second aim, we assessed whether there were changes in the neuro-immune-endocrine profiles within each group. Blood samples were collected before anesthesia, 90 min after anesthesia induction, and the day after surgery. We assessed serum cytokines using a cytometric bead array and hs-CRP by chemiluminescent immunoassay. Expression of three proinflammatory transcripts was assessed by real-time quantitative polymerase chain reaction, and neuroendocrine hormones were detected by chemiluminescent microparticle immunoenzymatic assay. There were no significant between-group differences for any analyzed biomarkers. However, there was a significant increase in: (a) systemic IL-6 and hs-CRP values one day after surgery in both groups and (b) prolactin levels in the intraoperative period compared to baseline and postoperative period levels for both groups. In conclusion, N2O does not impair the inflammatory profile and neuroendocrine response compared to patients who receive only desflurane anesthesia.

Descrição

Palavras-chave

Anesthetic gas, Gene transcription, Hormones, Inhalation anesthetic, Mediators of inflammation, Minor surgery

Como citar

International Immunopharmacology, v. 90.