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A comparison of the immunological effects of propofol and isoflurane for maintenance of anesthesia in healthy dogs.

ABSTRACT: Most anesthetics have an immuno-suppressive effect on cellular and neurohumoral immunity, and research shows that total intravenous anesthesia (TIVA) with propofol has a greater immuno-protective effect than inhalational anesthesia in human medicine. However, in veterinary clinics, these effects remain ambiguous. To clarify the details, we focused on propofol and isoflurane, investigating clinical blood hematology and immunological profiles drawn from healthy dogs under and after two anesthesia techniques. Twelve healthy adult beagles were included in this study, randomly assigned to the propofol anesthesia group (group P: n=6) or the isoflurane anesthesia group (group I: n=6). In both groups, the number of lymphocytes in peripheral blood decreased after 2 hr of anesthesia (2 hr), but group P showed significantly less decrease than group I. For T-lymphocyte subsets examined by flowcytometry, the ratio of CD3+, CD4+ and CD8+ lymphocytes in the peripheral blood mononuclear cell (PBMC) of group P at 2 hr also exhibited a high level compared to group I. Moreover, for mRNA expression of cytokines measured by real-time PCR, the IL2 (pro-inflammatory cytokine) of group P showed no decrease like group I. The IL10 (anti-inflammatory cytokine) of group P also showed no increase like group I, while both cytokines maintained nearly the same level until 2 hr. These results suggest that, compared to propofol, isoflurane had more strongly immuno-suppression caused by anesthesia, and propofol itself might have some immuno-protective effects. Thus, TIVA with propofol might benefit immunological support in the perioperative period of dogs.

SUBMITTER: Tomihari M

PROVIDER: S-EPMC4638288 | biostudies-literature | 2015 Oct

REPOSITORIES: biostudies-literature

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A comparison of the immunological effects of propofol and isoflurane for maintenance of anesthesia in healthy dogs.

Tomihari Mizuki M Nishihara Akira A Shimada Terumasa T Yanagawa Masashi M Miyoshi Masafumi M Miyahara Kazurou K Oishi Akihiro A

The Journal of veterinary medical science 20150511 10

Most anesthetics have an immuno-suppressive effect on cellular and neurohumoral immunity, and research shows that total intravenous anesthesia (TIVA) with propofol has a greater immuno-protective effect than inhalational anesthesia in human medicine. However, in veterinary clinics, these effects remain ambiguous. To clarify the details, we focused on propofol and isoflurane, investigating clinical blood hematology and immunological profiles drawn from healthy dogs under and after two anesthesia ...[more]

PMID: 25960120

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Project description:Background:Target-controlled infusion (TCI) propofol and sevoflurane are common agents for general anesthesia, including for kidney transplantation procedure. This study compared the effect of TCI propofol and sevoflurane on intraoperative hemodynamic profile in kidney transplant patients. Methods:A single-blinded prospective study was performed in 46 kidney transplant recipients who were randomized into receiving TCI propofol or sevoflurane as anesthetics maintenance. Hemodynamic parameters such as mean arterial pressure (MAP), cardiac index (CI), stroke volume index (SVI), and systemic vascular resistance index (SVRI) were measured at baseline before induction, postintubation, first surgical incision, every 15 minutes after the first incision, reperfusion, and 15 minutes after reperfusion. Data were analyzed using unpaired t-test, paired t-test, and general linear model. Results:Intraoperative MAP, CI, SVI, and SVRI changes were similar in both groups (p?=?0.480, 0.216, 0.086, and 0.054). In comparison to the baseline value, TCI propofol and sevoflurane groups showed significant reductions of MAP at postintubation (p=0.010; p < 0.001) and during the first surgical incision (p=0.009; p < 0.001); significant reduction of CI at postintubation (p=0.003; p < 0.001) and during the first surgical incision (p < 0.001; p < 0.001); significant reduction of SVI at postintubation (p=0.013; p=0.008), during the first surgical incision (p=0.008; p=0.003), and 15 minutes after reperfusion (p=0.010; p=0.005); and significant increasing of SVRI during the first surgical incision (p=0.007; p=0.005). The TCI propofol group showed significantly lower SVRI compared to the sevoflurane group postintubation (p=0.029) and during the first surgical incision (p=0.026). Conclusion:Intraoperative hemodynamic profile was similar between the TCI propofol and sevoflurane group during kidney transplant surgery. The TCI propofol group had higher CI and SVI but showed significantly lower SVRI as compared to the sevoflurane group. The incidence of postanesthesia agitation, postoperative outcome, and complication were not significantly different between the two groups.

Project description:The disruption of coupling between brain areas has been suggested as the mechanism underlying loss of consciousness in anesthesia. This hypothesis has been tested previously by measuring the information transfer between brain areas, and by taking reduced information transfer as a proxy for decoupling. Yet, information transfer is a function of the amount of information available in the information source-such that transfer decreases even for unchanged coupling when less source information is available. Therefore, we reconsidered past interpretations of reduced information transfer as a sign of decoupling, and asked whether impaired local information processing leads to a loss of information transfer. An important prediction of this alternative hypothesis is that changes in locally available information (signal entropy) should be at least as pronounced as changes in information transfer. We tested this prediction by recording local field potentials in two ferrets after administration of isoflurane in concentrations of 0.0%, 0.5%, and 1.0%. We found strong decreases in the source entropy under isoflurane in area V1 and the prefrontal cortex (PFC)-as predicted by our alternative hypothesis. The decrease in source entropy was stronger in PFC compared to V1. Information transfer between V1 and PFC was reduced bidirectionally, but with a stronger decrease from PFC to V1. This links the stronger decrease in information transfer to the stronger decrease in source entropy-suggesting reduced source entropy reduces information transfer. This conclusion fits the observation that the synaptic targets of isoflurane are located in local cortical circuits rather than on the synapses formed by interareal axonal projections. Thus, changes in information transfer under isoflurane seem to be a consequence of changes in local processing more than of decoupling between brain areas. We suggest that source entropy changes must be considered whenever interpreting changes in information transfer as decoupling.

Project description:BackgroundOptimal dosing of propofol to maintain appropriate anesthetic depth is challenging in severely obese (SO) adolescents. We previously reported that total body weight (TBW) is predictive of propofol clearance. This study was aimed at characterizing pharmacokinetics (PK) and pharmacodynamics (PD) of propofol in SO adolescents, using bispectral index (BIS), and toward developing PK/PD model-based dosing guidelines.MethodsA prospective PK/PD study was conducted in 26 SO children and adolescents aged 9-18 years (body mass index 31-69 kg·m(-2)), undergoing surgery with intravenous propofol anesthesia clinically titrated by providers blinded to BIS. BIS data and propofol infusion schemes were recorded. Venous blood samples collected during and after propofol infusion were assayed for propofol concentrations. A propofol PK/PD model was developed using NONMEM and model-based simulations were performed to determine propofol dosing regimens targeting BIS of 50 ± 10.ResultsA three-compartment PK model linked to a sigmoidal inhibitory Emax PD model by a first-order rate constant, adequately described the propofol concentration (n = 375) and BIS (n = 3334) data. TBW was the most predictive covariate for propofol clearance [CL (l·min(-1) ) = 1.65 × (TBW/70)(0.75)]. An effect-site propofol concentration of 3.19 μg·ml(-1) was estimated for half-maximal effect, with no identifiable predictive covariates. The proposed maintenance dosing regimen targeted to a BIS of 50 ± 10, based on our PK/PD model, was able to predict desired propofol concentrations and BIS in a representative obese teen when used in conjunction with accepted PK/PD models for children/obese adults (PK:Eleveld/PD: Cortinez), further supporting evidence for the dosing based on TBW.ConclusionThis is the first study to describe the PK/PD of propofol in SO adolescents. The proposed maintenance dosing regimen for propofol uses TBW in an allometric function as a dosing scalar, with an exponent of 0.75. Our results suggest no relevant effect of obesity on the propofol concentration-BIS relationship.

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A comparison of the immunological effects of propofol and isoflurane for maintenance of anesthesia in healthy dogs.

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A comparison of the immunological effects of propofol and isoflurane for maintenance of anesthesia in healthy dogs.

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