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Br J Anaesth. 2007 Oct;99(4):522-7. Epub 2007 Aug 6.

Low-dose ketamine affects immune responses in humans during the early postoperative period.

Author information

1
Department of Anaesthesiology and Research Institute, Rabin Medical Center, Hasharon Hospital, 7, Keren Kayemet Street, Petah Tiqva 47372, Israel. beilinb@clalit.org.il

Abstract

BACKGROUND:

Anaesthesia and surgery are associated with impairment of the immune system expressed as an excessive proinflammatory immune response and suppression of cell-mediated immunity that may affect the course of the postoperative period. Addition of anaesthetic agents capable of attenuating the alterations in perioperative immune function may exert a favourable effect on patients' healing. We have assessed the effect of preoperative administration of a sub-anaesthetic dose of ketamine on the mitogen response and production of interleukin (IL)-1beta, IL-2, IL-6, and tumour necrosis factor (TNF)-alpha by peripheral blood mononuclear cells (PBMCs), as well as natural killer cell cytotoxicity (NKCC) in patients undergoing abdominal surgery.

METHODS:

Seventeen patients admitted for elective abdominal surgery were given ketamine 0.15 mg kg(-1) i.v. 5 min before induction of general anaesthesia. Nineteen patients received a similar volume of isotonic saline 5 min before induction of the anaesthesia. PBMCs were isolated from venous blood before and 4, 24, 48, and 72 h after operation for IL-1beta, IL-2, IL-6, and TNF-alpha secretion, and NKCC assessment.

RESULTS:

Four hours after operation, the cells from patients in the ketamine group showed a significantly suppressed production of IL-6 (P < 0.01) compared with controls. The production of IL-2 did not change from that of the preoperation samples. TNF-alpha secretion was significantly elevated in the control group 4 h after operation (P < 0.05).

CONCLUSIONS:

Addition of small doses of ketamine before induction of anaesthesia resulted in attenuation of secretion of the proinflammatory cytokines IL-6 and TNF-alpha, and in preservation of IL-2 production at its preoperative level. It is suggested that this anaesthetic may be of value in preventing immune function alterations in the early postoperative period.

PMID:
17681970
DOI:
10.1093/bja/aem218
[Indexed for MEDLINE]
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