Anaesthesia with propofol decreases FMLP-induced neutrophil respiratory burst but not phagocytosis compared with isoflurane

Propofol has been reported to produce a dose-dependent inhibition of phagoc ytosis and superoxide anion production during the respiratory burst (RB) of polymorphonuclear cells (PMNs) in vitro. In this randomized, blinded study , these two parameters were compared during propofol or isoflurane anaesthe sia in patients undergoing elective interventional embolization of cerebral arterio-venous malformations. Anaesthesia was performed with continuous in travenous propofol 6-8 mg kg(-1) h(-1) (n=15) or isoflurane 0.8-1.0% end ti dal (n=15). Heparinized blood was drawn before, and 2 and 4 h after inducti on of anaesthesia. The RE in isolated leucocytes was measured with the fluo rescent dye rhodamine after ex vivo induction by Escherichia coil or tumour necrosis factor alpha/N-formyl-methionyl-leucylphenylalanine (TNF-alpha/FM LP). Phagocytosis was carried out in whole blood after incubation with fluo rescein isothiocyanate (FITC)-labelled, opsonized E. coli and also measured with a flow cytometer. The Mo groups were similar in terms of biometric da ta and haemodynamic responsiveness. After 4 h of propofol or isoflurane ana esthesia, the mean (SD) phagocytosis of E. coil was 93.2% (7.0%) and 94.3% (9.2%), respectively, of that before anaesthesia. The percentage of PMN wit h RE activity following TNF-alpha/FMLP stimulation was significantly reduce d after 2 h (80.9% (24.2%); P<0.05) and 4 h (53.7% (27.3); P<0.05) of anaes thesia with propofol compared with the values before induction. This effect of propofol anaesthesia was significantly different from the effect of iso flurane anaesthesia. In contrast to published in vitro results, 4 h of anae sthesia with propofol did not reduce the phagocytotic capacity of human blo od PMN more than isoflurane anaesthesia.