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Anesthesiology Research and Practice
Volume 2011 (2011), Article ID 317410, 6 pages
http://dx.doi.org/10.1155/2011/317410
Research Article

Immunomodulatory Effects of Anesthetics during Thoracic Surgery

Department of Anesthesiology, Faculty of Medicine, Minoufiya University, 3 Yaseen Abdelghaffar Street, Shebin Elkoam, Minoufiya 32511, Egypt

Received 9 July 2011; Revised 16 August 2011; Accepted 5 September 2011

Academic Editor: S. Neustein

Copyright © 2011 Khaled Mahmoud and Amany Ammar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. One-lung ventilation (OLV) during thoracic surgery may induce alveolar cell damage and release of proinflammatory mediators. The current trial was planned to evaluate effect of propofol versus isoflurane anesthesia on alveolar and systemic immune modulation during thoracic surgery. Methods. Fifty adult patients undergoing open thoracic surgery were randomly assigned to receive propofol ( 𝑛 = 2 5 ) or isoflurane ( 𝑛 = 2 5 ) anesthesia. The primary outcome measures included alveolar and plasma concentrations of interleukin-8(IL-8) and tumour necrosis factor-α (TNF-α), whereas secondary outcome measures were alveolar and plasma concentrations of malondialdehyde (MDA), superoxide dismutase (SOD), and changes in alveolar albumin concentrations and cell numbers. Results. Alveolar and plasma concentrations of IL-8 and TNF-α were significantly lower in the isoflurane group, whereas alveolar and plasma concentrations of MDA were significantly lower in the propofol group. Alveolar and plasma SOD levels increased significantly in the propofol group whereas they showed no significant change in the isoflurane group. Furthermore, the isoflurane group patients developed significantly lower alveolar albumin concentrations and cell numbers. Conclusion. Isoflurane decreased the inflammatory response associated with OLV during thoracic surgery and may be preferable over propofol in patients with expected high levels of proinflammatory cytokines like cancer patients.