Anesthesia drugs, immunity, and long-term outcome

Jay A. Homburger, Steffen E Meiler

Research output: Contribution to journalReview article

56 Citations (Scopus)

Abstract

PURPOSE OF REVIEW: We provide an overview of the immunological effects of commonly used anesthetic drugs and highlight their potential impact on long-term outcome after surgery. RECENT FINDINGS: Clinical trials provide preliminary evidence that the perioperative process can influence long-term patient outcome. Immunology may begin to elucidate the biology of this safety concern and open new therapeutic opportunities. In this context, awareness of the immunological properties of drugs administered in the perioperative period may assist in their deliberate use to modulate this risk. Statins, β-blockers, and clonidine can potentially improve long-term cardiac risk. Volatile anesthetics appear to suppress effector functions of both the innate and adaptive immunity, assist tumor growth in animal models, and facilitate aggregation of certain neurodegenerative disease proteins. Local anesthetics block neurons, but are also potent antiinflammatory drugs. Morphine has recognized immunosuppressive functions, which the newer, synthetic opioids don't seem to share. The cholinergic nervous system has antiinflammatory control functions that are largely unexploited. SUMMARY: Long-term outcome after surgery is a new safety concern in perioperative care. We are faced with enormous challenges in healthcare and research. As providers, tailoring an anesthetic plan to patients' needs will become increasingly critical, and immunology should help in this pursuit.

Original languageEnglish (US)
Pages (from-to)423-428
Number of pages6
JournalCurrent Opinion in Anaesthesiology
Volume19
Issue number4
DOIs
StatePublished - Aug 1 2006

Fingerprint

Anesthetics
Immunity
Anesthesia
Allergy and Immunology
Anti-Inflammatory Agents
Pharmaceutical Preparations
Perioperative Care
Safety
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Perioperative Period
Health Services Research
Clonidine
Adaptive Immunity
Immunosuppressive Agents
Local Anesthetics
Innate Immunity
Neurodegenerative Diseases
Morphine
Cholinergic Agents
Opioid Analgesics

Keywords

  • Anesthesiology
  • Drugs
  • Immunity
  • Inflammation
  • Outcome

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Anesthesia drugs, immunity, and long-term outcome. / Homburger, Jay A.; Meiler, Steffen E.

In: Current Opinion in Anaesthesiology, Vol. 19, No. 4, 01.08.2006, p. 423-428.

Research output: Contribution to journalReview article

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