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Abstract
The mechanism of decreased lymphocyte responsiveness after major surgery is unclear.
Because sodium pentobarbital, an intermediately long-acting barbiturate, will reproducibly
induce anesthesia in experimental animals, we utilized a canine model to investigate
its effect on lymphocyte proliferation induced by the mitogenic lectins erythroagglutinating
phytohemagglutinin (E-PHA) and leukoagglutinating phytohemagglutinin (L-PHA). Although
no effect was observed at 10 minutes or 1 hour after an anesthetic dose of sodium
pentobarbital, after 2 and 3 hours of anesthesia, canine lymphocytes were significantly
suppressed, as demonstrated by decreased responsiveness to E-PHA and L-PHA mitogen
stimulation. After 3-hours the majority of animals had mitogenesis values of less
than 50% of the preanesthetic control values. Recovery, as measured by a return to
at least 70% of the preanesthetic mitogenesis value, was noted in the majority of
animals at 24, 48, and 72 hours. In order to investigate the mechanisms of the in
vivo capability of sodium pentobarbital to induce immunosuppression of lymphocyte
transformation, in vitro studies were earned out. Sodium pentobarbital was found to
significantly inhibit mitogen-induced canine mononuclear cell blastogenesis at anesthetic
(1.5 to 3.0 mg%) drug concentrations in vitro. Lymphocytes pretreated with barbiturate
and washed prior to plating did not show this inhibiting effect. Our findings suggest
that depression of the immune response reported in patients after operation could
result from short-acting barbiturates administered during the induction phase of clinical
anesthesia. Furthermore, the suppression may involve in vivo metabolism of pentobarbital,
hormones or other in vivo factors, since washed lymphocytes from the in vivo but not
the in vitro experiments demonstrated suppression. These results indicate that anesthesia
may be an important factor in the immunosuppression reported after major surgery.
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Article info
Publication history
Accepted:
October 11,
1979
Identification
Copyright
© 1980 Published by Elsevier Inc.