THE INFLUENCE OF ANESTHETIC TECHNIQUE UPON THE IMMUNE-RESPONSE TO HYSTERECTOMY - A COMPARISON OF PROPOFOL INFUSION AND ISOFLURANE

Earlier studies on propofol have shown increased percentages of T help er cells after minor surgery. In this study, the effects of propofol i nfusion anaesthesia on the immune response were compared with those of combined isoflurane anaesthesia in 30 patients (median age 47 years, ASA 1-2) undergoing major surgery. The total dose of propofol in the p ropofol infusion group of 15 women was 860 mg (range 540-1520 mg) and the median end-expiratory isoflurane concentration in the combined iso flurane group of 15 women was 0.6% (range 0.5-0.8). The following were measured; leucocyte and differential counts; percentages of lymphocyt e subpopulations (CD3, CD4, CD8, CD19, CD16 and HLA-DR + CD3); phytoha emagglutinin-, concanavalin A-, and pokeweed mitogen-induced and unsti mulated lymphocyte proliferation; plasma interleukin-6; serum group Il phospholipase A2, C-reactive protein and cortisol concentrations. Mea surements were made pre-operatively, at the end of the operation and o n the first and fifth postoperative days. No statistically significant overall differences were observed in the immune response between the groups. The serum cortisol response,vas weaker in the propofol group t han in the isoflurane group (p < 0.05). Time-related changes were seen within the groups.