O'Donnell N G, McSharry C P, Wilkinson P C, Asbury A J
University Department of Anaesthesia, Western Infirmary, Glasgow.
Br J Anaesth. 1992 Jul;69(1):70-4. doi: 10.1093/bja/69.1.70.
Anaesthetic agents inhibit some aspects of immune function and this may be clinically important when prolonged infusions are used in an intensive care unit. We have studied the effects of propofol, thiopentone and midazolam on neutrophil polarization in vitro. At concentrations seen in plasma during anaesthesia, propofol and thiopentone produced significant (approximately 50%) and comparable degrees of inhibition. Inhibition was complete with greater concentrations of these drugs. When compared with equivalent concentrations of midazolam, propofol produced more inhibition (P less than 0.01) at all concentrations investigated, except the smallest. Midazolam produced no effect at clinically relevant concentrations. The effect of propofol was not attributable to its lipid carrier vehicle, as 10% Intralipid alone augmented neutrophil polarization. Human serum albumin conferred some degree of protection against the inhibition produced by clinically relevant concentrations of propofol and thiopentone, but not that produced by greater concentrations of these drugs.
麻醉剂会抑制免疫功能的某些方面，当在重症监护病房使用长时间输注时，这在临床上可能很重要。我们研究了丙泊酚、硫喷妥钠和咪达唑仑对体外中性粒细胞极化的影响。在麻醉期间血浆中所见的浓度下，丙泊酚和硫喷妥钠产生了显著（约50%）且相当程度的抑制作用。更高浓度的这些药物会导致完全抑制。与等效浓度的咪达唑仑相比，在所有研究浓度下，除了最小浓度外，丙泊酚产生的抑制作用更强（P小于0.01）。咪达唑仑在临床相关浓度下没有作用。丙泊酚的作用并非归因于其脂质载体，因为单独的10%脂肪乳会增强中性粒细胞极化。人血清白蛋白对临床相关浓度的丙泊酚和硫喷妥钠产生的抑制有一定程度的保护作用，但对这些药物更高浓度产生的抑制则没有保护作用。
