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Remifentanil-induced alterations in neutrophil numbers after surgery

Toshiichro Inagi1, Hideko Hoshina2, Manzo Suzuki1

  • 1Department of Anesthesiology, Musashikosugi Hospital Nippon Medical School, 1-396 Kosugi-cho Nakahara-ku, Kawaski, Kanagawa 211-8533 Japan.

JA Clinical Reports
|March 2, 2018
PubMed
Abstract

Insights

Remifentanil anesthesia, compared to fentanyl, significantly reduces postoperative white blood cell and neutrophil counts. Further research is needed to determine if this indicates immunosuppression.

Area of Science:

  • Anesthesiology
  • Immunology
  • Oncology

Background:

  • Neutrophils are critical for defense against pathogens during and after surgery.
  • Opioid analgesics may differentially impact leukocyte counts postoperatively.
  • Retrospective analysis of surgical patients receiving remifentanil- vs. fentanyl-based anesthesia.

Purpose of the Study:

  • To compare the effects of remifentanil-based and fentanyl-based anesthesia on postoperative leukocyte and neutrophil counts.
  • To investigate potential differences in immune cell response to different opioid analgesics.

Main Methods:

  • Retrospective analysis of 83 female patients undergoing mastectomy (January 2010-December 2013).
  • Propensity score matching based on age and procedure.
  • Analysis of 40 matched patients (20 per group: remifentanil vs. fentanyl).

Main Results:

  • Significantly lower postoperative leukocyte and neutrophil counts in the remifentanil group (p=0.03, p=0.014).
  • Significantly lower increases in leukocyte and neutrophil counts in the remifentanil group (p=0.009, p=0.0046).

Conclusions:

  • Remifentanil-based anesthesia attenuates postoperative leukocyte and neutrophil counts.
  • The clinical significance, particularly regarding potential immunosuppression, requires further investigation.
  • Further studies are warranted to elucidate the immunological implications.
Keywords:
AnesthesiaNeutrophil countsRemifentanilSurgery

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