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The effects of thiopentone, etomidate, ketamine and midazolam on several bactericidal functions of polymorphonuclear

W Krumholz1, C Demel, S Jung

  • 1Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany.

European Journal of Anaesthesiology
|March 1, 1995
PubMed

Insights

Thiopentone anesthesia significantly impairs polymorphonuclear leucocyte (PMNL) functions, reducing key bactericidal agents. Other tested anesthetics showed minimal impact on these crucial immune cells, suggesting potential infection risks with thiopentone.

Area of Science:

  • Immunology
  • Anesthesiology
  • Pharmacology

Background:

  • Polymorphonuclear leucocytes (PMNL) are critical for combating bacterial infections.
  • Certain anesthetics may suppress PMNL functions, potentially increasing perioperative infection risk.

Purpose of the Study:

  • To investigate the in vitro effects of thiopentone, etomidate, ketamine, and midazolam on PMNL bactericidal agent generation.

Main Methods:

  • Assessed the impact of four anesthetics on superoxide anion, hydrogen peroxide, and myeloperoxidase production by PMNL.
  • Utilized in vitro assays to quantify the generation of these bactericidal agents.

Main Results:

  • Thiopentone significantly inhibited superoxide anion and hydrogen peroxide production by PMNL (P < 0.01 and P < 0.001, respectively).
  • Etomidate and ketamine demonstrated no significant influence on tested PMNL functions.
  • Midazolam suppressed superoxide anion generation only at concentrations exceeding clinical relevance.

Conclusions:

  • Thiopentone exhibits inhibitory effects on PMNL bactericidal functions, potentially contributing to perioperative infections.
  • Etomidate, ketamine, and clinically relevant concentrations of midazolam do not appear to significantly impair PMNL functions.

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