INFLUENCE OF INHALATIONAL, NEUROLEPTIC AND LOCAL-ANESTHESIA ON LYMPHOCYTE SUBSET DISTRIBUTION

We previously demonstrated that anaesthetics affect leukocyte response by inhibiting lymphocyte capping and metabolism and the phagocytic ac tivity of neutrophils in some experimental models. In the present stud y, we investigated the effects of the clinical use of three different types of anaesthesia on lymphocyte subset distribution and activity. I nhalational anaesthesia (isoflurane), a neuroleptoanalgesia, or local anaesthesia was used in patients submitted to the same operation (hyst erectomy). At time 0 (before administering the anaesthesia) and at 10 min and 48 h from the start of the operation, heparinized blood was ob tained from each of the 30 patients studied; three lymphocyte subpopul ations were isolated (CD4+, CD8+ and CD19+). Cell number was identifie d for each lymphocyte subset, and (as an indication of cellular functi on) the intracellular contents of ATP and cAMP were evaluated by lumin escence methods. The relevant results for each of the 3 anaesthetic me thods were as follows. i) treatment with isoflurane induced a signific ant reduction in the number and function of CD4+ cells at 10 min, whic h was reversed at 48 h; a functional but not reversible decrease of CD 19+ cells was obtained, ii) treatment with neuroleptic drugs induced a significant progressive functional impairment of CD4+ and CD19+ cells , and iii) local anaesthesia caused a significant functional impairmen t of CD8+ cells al 48 h and a significant functional impairment of CD1 9+ cells at 10 min and 48 h.