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Anästhesie und Immunreaktivität

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Die Anästhesiologie

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Zusammenfassung

Die inflammatorische Antwort nach einem operativen Eingriff stellt wahrscheinlich das biologische Bindeglied zwischen Operationen, dem anästhesiologischen Management und dem Outcome dar. Der operative Eingriff und die Wahl des Anästhesieverfahrens per se können ebenfalls die Immunreaktivität multifaktoriell und komplex beeinflussen. Klinisch manifestiert sich eine systemische inflammatorische Entzündungsreaktion („SIRS“), die neben günstigen Effekten wie der verbesserten Wundheilung oder Geweberegeneration auch komplexe immunsuppressive Wirkungen aufweist. Die Folge ist eine überschießende und/oder abgeschwächte Immunreaktivität unmittelbar postoperativ mit einem erhöhten Risiko für Komplikationen.

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Literatur

  1. Adam SD, Radhakrishnan RS, Helmer KS, Mercer DW (2008) Effects of anesthesia on lipopolysaccharide-induced changes in serum cytokines. J Trauma 60:170–174

    Google Scholar 

  2. Delves PJ, Roitt IM (2000) The immune system. Second of two parts. N Engl J Med 343:108–117

    CAS  PubMed  Google Scholar 

  3. Robertson CM, Coopersmith CM (2006) Systemic inflammatory response syndrome. Microbes Infect 8:1382–1389

    CAS  PubMed  Google Scholar 

  4. Schroeder S, Wichers M, Klingmueller D et al (2001) The hypothalamic-pituitary-adrenal axis of patients with severe sepsis: altered response to corticotropin-releasing hormone. Crit Care Med 29:310–316

    CAS  PubMed  Google Scholar 

  5. Sorrels S, Sapolsky RM (2007) An inflammatory review of glucocorticoid actions in the CNS. Brain Behav Immun 21:259–272

    Google Scholar 

  6. von Dossow V, Sander M, McGill M et al (2008) Perioperative cell-mediated immune response [Review]. Front Biosci 13:3676–3684

    Google Scholar 

  7. Baldini G, Bagry H, Carli F (2008) Depth of anesthesia with desflurane does not influence the endocrine-metabolic response to pelvis surgery. Acta Anaesthesiol Scand 52:99–105

    CAS  PubMed  Google Scholar 

  8. Baue AE (2003) Sepsis, systemic inflammatory response syndrome, multiple organ dysfunction syndrome, and multiple organ failure: are trauma surgeons lumpers or splitters? J Trauma 55:997–998

    PubMed  Google Scholar 

  9. Choileain NN, Redmond PH (2006) Cell response to surgery. Arch Surg 141:1132–1140

    Google Scholar 

  10. Christopherson R, James KE, Tableman M, Marshall P, Johnson FE (2008) Long-term survival after colon cancer surgery: a variation associated with choice of anesthesia. Anesth Analg 107(1):325–332

    PubMed  Google Scholar 

  11. Coventry TL, Jessop DS, Finn DP et al (2001) Endomorphines and activation of the hypothalamo-pituitary-adrenal axis. J Endocrinol 169:185–193

    CAS  PubMed  Google Scholar 

  12. Kimura F, Shimizu H, Yoshidome H et al (2006) Circulating cytokines, chemokines and stress hormones are increased in patients with organ dysfunction following liver resection. J Surg Res 133:102–112

    CAS  PubMed  Google Scholar 

  13. Kimura F, Shimizu H, Yoshidome H et al (2006) Increased plasma levels of IL-6 and IL-8 are associated with surgical site infection after pancreaticoduodenectomy. Pancreas 32:178–185

    CAS  PubMed  Google Scholar 

  14. Koerner P, Westerholt A, Kessler W et al (2008) Operatives trauma and postoperative Immunsuppression. Chirurg 79:290–294

    CAS  PubMed  Google Scholar 

  15. Lin E, Calvano SE, Lowry SF (2000) Inflammatory cytokines and cell response in surgery. Surgery 127:117–126

    CAS  PubMed  Google Scholar 

  16. Loisa P, Rinne T, Laine S et al (2003) Anti-inflammatory cytokine response and the development of multiple organ failure in severe sepsis. Acta Anaesth Scand 47:319–325

    CAS  PubMed  Google Scholar 

  17. Manderscheid PA, Bodkin RP, Davidson BA et al (2004) Bacterial Clearance and cytokine profiles in a murine model of postsurgical nosocomial pneumonia. Clin Diagn Lab Immunol 11:742–751

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Matsuda A, Furukawa K, Suzuki H et al (2007) Does impaired Th1/Th2 balance cause postoperative infectious complications in colorectal cancer surgery? J Surg Res 139:15–21

    CAS  PubMed  Google Scholar 

  19. Miyaoka K, Iwase M, Suzuki R et al (2005) Clinical evaluation of circulating interleukin-6 and interleukin-10 levels after surgery-induced inflammation. J Surg Res 125:144–150

    CAS  PubMed  Google Scholar 

  20. Roy S, Wang J, Gupta S et al (2004) Chronic morphine treatment differentiates T helper cells to Th2 effector cells by modulating transcription factors GATA-3. J Neuroimmunol 147:78–81

    CAS  PubMed  Google Scholar 

  21. Taniguchi T, Koido Y, Aiboshi J et al (1999) The ratio of interleukin-6 to interleukin-10 correlates with severity in patients with chest and abdominal trauma. Am J Emerg Med 17:549–551

    Google Scholar 

  22. Tatsumi H, Ura H, Ikeda S et al (2003) Surgical influence on Th1/Th2 balance and monocyte surface antigen expression and its relation to infectious complications. World J Surg 27:522–528

    PubMed  Google Scholar 

  23. Desborough JP (2000) The stress response to trauma and surgery. Br J Anaesth 85:109–117

    CAS  PubMed  Google Scholar 

  24. Dimipoulou I, Tzanela M, Vassiliadi D et al (2008) Pituitary-adrenal responses following major abdominal surgery. Hormones 7:237–242

    Google Scholar 

  25. Momersteeg PM, Heijnen CJ, Kavelaars A et al (2008) The HPA-axis and immune function in burnout. Prog Brain Res 167:281–285

    Google Scholar 

  26. Molina PE (2005) Neurobiology of the stress response: contribution of the sympathetic nervous system to the neuroimmune axis in traumatic injury. Shock 24:3–10

    CAS  PubMed  Google Scholar 

  27. Sander M, von Heymann C, Neumann T et al (2005) Increased interleukin-10 and cortisol in long-term alcoholics after cardiopulmonary bypass: a hint to the increased postoperative infection rate. ACER 29:1677–1684

    CAS  Google Scholar 

  28. Shimaoka M, Hosotsubo K, Sugimoto M et al (1998) The influence of surgical stress on T cells: enhancement of early phase lymphocyte activation. Anesth Analg 87:1431–1435

    CAS  PubMed  Google Scholar 

  29. Inada T, Yamanouchi Y, Jomura S et al (2004) Effect of propofol and isoflurane anaesthesia on the immune response to surgery. Anaesthesia 59:954–959

    CAS  PubMed  Google Scholar 

  30. Döcke WD, Höflich C, Davis KA et al (2005) Monitoring temporary immunodepression by the flow cytometric measurement of monocytic HLA-Dr expression: a multicenter standardized study. Clin Chem 51:2341–2347

    PubMed  Google Scholar 

  31. Oszenski W, Krenn H, Jilich R et al (2003) HLA-Dr as a marker increased risk for systemic inflammation and septic complications after cardiac surgery. Intensive Care Med 29:1253–1257

    Google Scholar 

  32. Perry SE, Mostafa SM, Wenstone R et al (2003) Is low monocyte HLA-DR expression helpful to predict outcome in severe sepsis? Intensiv Care Med 29:1245–1252

    Google Scholar 

  33. Hirai S (2003) Systemic inflammatory response syndrome after cardiac surgery under cardiopulmonary bypass. Ann Thorac Cardiovasc Surg 9:365–370

    PubMed  Google Scholar 

  34. Horisberger T, Habarth S, Nadal D, Baenziger O, Fischer JE (2004) G-CSF and IL-8 for early diagnosis of sepsis in neonates and critically ill children- safety and cost effectiveness of a new laboratory prediction model: study protocol of a randomized controlled trial. Crit Care 8:R443–R450

    PubMed  PubMed Central  Google Scholar 

  35. Mokart D, Capo C, Blache JL et al (2002) Early postoperative compensatory anti-inflammatory response syndrome is associated with septic complications after major surgical trauma in patients with cancer. Br J Surg 89:1450–1456

    CAS  PubMed  Google Scholar 

  36. Sander M, Irwin M, Sinha P et al (2002) Suppression of interleukin-6 to interleukin-10 ratio in chronic alcoholics: association with postoperative infections. Intensive Care Med 28:285–292

    CAS  PubMed  Google Scholar 

  37. Sander M, von Heymann C, von Dossow V et al (2006) Increased interleukin-6 after cardiac surgery predicts infection. Anesth Analg 102:1623–1629

    CAS  PubMed  Google Scholar 

  38. Poeze M, Ramsay G, Buurman WA et al (2002) Increased hepatosplanchnic inflammation precedes the development of organ dysfunction after elective high-risk surgery. Shock 17:451–458

    PubMed  Google Scholar 

  39. Irwin M, Miller C (2000) Decreased natural killer cell responses and altered interleukin-6 and interleukin-10 production in alcoholism: an interaction between alcohol dependence and African-American ethnicity. Alcohol Exp Res 24:560–569

    CAS  Google Scholar 

  40. Wilhelm W, Wrobel M, Kreuer S et al (2003) Remifentanil. An up-date. Anaesthesist 52:473–494

    CAS  PubMed  Google Scholar 

  41. Song HK, Jeong DC (2004) The effect of propofol on cytotoxicity and apoptosis of lipopolysaccharide-treated mononuclear cells and lymphocytes. Anesth Analg 98:1724–1728

    CAS  PubMed  Google Scholar 

  42. von Dossow V, Luetz A, Hass A et al (2008) Effects of remifentanil and fentanyl on the cell-mediated immune response in patients undergoing elective coronary artery bypass graft surgery. JIMR 36:1235–1247

    Google Scholar 

  43. Schwenk W, Jacobi C, Mannsmann U et al (2000) Inflammatory response after laparoscopic and conventional colorectal resections-results of a prospective randomized trial. Langenbeck Arch Surg 385:2–9

    CAS  Google Scholar 

  44. Goldmann A, Hoehne C, Fritz GA, Unger J, Ahlers O, Nachtigall I, Boehmke W et al (2008) Combined versus isoflurane/fentanyl anesthesia for major abdominal surgery: effects on hormones and hemodynamics. Med Sci Monit 14:CR445–CR452

    CAS  PubMed  Google Scholar 

  45. Pirtikkangas CO, Salo M, Manisikka M et al (1995) The influence of anaesthetic technique upon the immune response to hysterectomy. A comparison of propofol infusion and isoflurane. Anaesthesia 50:1056–1061

    Google Scholar 

  46. Salo M, Pirttikangas CO, Pulkki K (1997) Effects of propofol emulsion and thiopenthone on T helper cell type-1/type-2 balance in vitro. Anaesthesia 52:341–344

    CAS  PubMed  Google Scholar 

  47. Schneemilch CE, Ittenson A, Ansorge S, Hachenberg T, Bank U (2005) Effect of 2 anesthetic techniques on the postoperative proinflammatory and anti-inflammatory cytokine response and cellular immune function to minor surgery. J Clin Anesth 17:517–527

    PubMed  Google Scholar 

  48. von Dossow V, Baur S, Sander M et al (2007) Propofol increased the Interleukin-6 to interleukin-10 ratio more than isoflurane after surgery in long-term alcoholic patients. JIMR 35:395–405

    Google Scholar 

  49. Welters I (2003) Opioide und Immunsuppression. Klinische Relevanz? Anaesthesist 52:442–452

    CAS  PubMed  Google Scholar 

  50. Hall R, Adderley N, MacLaren C et al (2000) Does intrathecal morphine alters stress response following coronary artery bypass graft surgery? Can J Anaesth 47:463–466

    CAS  PubMed  Google Scholar 

  51. Winterhalter M, Brandl K, Rahe-Meyer N et al (2008) Endocrine stress response and inflammatory activation during CABG surgery. A randomized trial comparing remifentanil infusion to intermittent fentanyl. Eur J Anaesthesiol 25:326–335

    CAS  PubMed  Google Scholar 

  52. Liu JH, Shen JM, Li L et al (2005) Effects of fentanyl on cytokines and MD during cardiopulmonary bypass in patients undergoing valve replacement. Zhong Nan Da Xue Xue Bao Yi Yue Ban 30:80–83

    Google Scholar 

  53. Shavit Y, Ben-Eliyahu S, Zeidel A et al (2002) Effects on fentanyl on natural killer cell activity and on resistance to tumor metastasis in rats. Dose and timing study. Neuroimmunomodulation 11:255–260

    Google Scholar 

  54. Wu Y, Wang Y, Zhan J (2009) Effects of remifentanil and fentanyl on LPS-induced cytokine release in whole blood in vitro. Mol Biol Rep 36:1113–1117

    CAS  PubMed  Google Scholar 

  55. Yardeni IZ, Beilin B, Mayburd E et al (2008) Relationship between fentanyl dosage and immune function in the postoperative period. J Opioid Manag 4:27–33

    PubMed  Google Scholar 

  56. Sacerdote P, Gaspani L, Rossoni G et al (2001) Effect of remifentanil on cellular immune response in the rat. Int Immunopharmacol 1:713–719

    CAS  PubMed  Google Scholar 

  57. Murphy GS, Szokol JW, Marymnt JH et al (2007) The effects of morphine and fentanyl on the inflammatory response to cardiopulmonary bypass in patients undergoing elective coronary bypass graft surgery. Anesth Analg 104:1334–1342

    CAS  PubMed  Google Scholar 

  58. Kaye AD, Patel N, Bueno FR et al (2014) Effect of opiates, anesthetic techniques, and other perioperative factors on surgical cancer patients. Ochsner J 14:216–228

    PubMed  PubMed Central  Google Scholar 

  59. Cakmakkaya OS, Kolodzie K, Apfel CA et al (2014) Anesthetic techniques for risk of malignant tumour recurrence. Rev Cochrane Collab 11:CD008877

    Google Scholar 

  60. Roy S, Wang J, Kelschenbach J et al (2006) Modulation of immune function by morphine: implication for susceptibility to infection. J Neuroimmune Pharmacol 1:77–89

    PubMed  Google Scholar 

  61. Sacerdote P, Bianchi M, Gaspani L et al (2000) The effects of tramadol and morphine on immune responses and pain after surgery in cancer patients. Anesth Analg 90:1411–1414

    CAS  PubMed  Google Scholar 

  62. Sacerdote P, Limorili E, Gaspani L (2003) Experimental evidence for immunmodulatory effects of opioids. Adv Exp Med Biol 521:16–116

    Google Scholar 

  63. Exadaktylos AK, Buggy DJ, Moriarty DC, Mascha E, Sessler DI (2006) Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis? Anesthesiology 105(4):660–664

    PubMed  PubMed Central  Google Scholar 

  64. Schlagenhauff B, Ellwanger U, Breuninger H et al (2000) Prognostic impact of the type of anesthesia used during the excision of primary cutaneous melanoma. Melanoma Res 10:165–169

    CAS  PubMed  Google Scholar 

  65. Binczak M, Tournay E, Billard V, Rey A, Jayr C (2013) Major abdominal surgery for cancer: does epidural analgesia have a long-term effect on recurrence-free and overall survival? Ann Fr Anesth Reanim 32(5):e81–e88

    CAS  PubMed  Google Scholar 

  66. Myles PS, Peyton P, Silbert B, Hunt J, Rigg JR, Sessler DI (2011) Perioperative epidural analgesia for major abdominal surgery for cancer and recurrence-free survival: randomised trial. BMJ 342:d1491

    PubMed  Google Scholar 

  67. Tsui BC, Rashiq S, Schopflocher D, Murtha A, Broemling S, Pillay J et al (2010) Epidural anesthesia and cancer recurrence rates after radical prostatectomy. Can J Anaesth 57(2):107–112

    PubMed  Google Scholar 

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Authors and Affiliations

  1. LMU München, Klink für Anaesthesiologie, Klinikum Großhadern, München, Deutschland

    Vera von Dossow-Hanfstingl

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  1. Vera von Dossow-Hanfstingl
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Correspondence to Vera von Dossow-Hanfstingl .

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Editors and Affiliations

  1. Klinik für Anästhesiologie, Universitätsklinikum Aachen RWTH Aachen, Aachen, Germany

    Rolf Rossaint

  2. Klinik für Anästhesiologie, Universitätsklinikum Mainz, Mainz, Germany

    Christian Werner

  3. Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum München Klinikum Großhadern, München, Germany

    Bernhard Zwißler

Section Editor information

  1. Klinikum der Universität München, Klinik für Anästhesiologie, München, Germany

    Bernhard Zwißler

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Dossow-Hanfstingl, V.v. (2019). Anästhesie und Immunreaktivität. In: Rossaint, R., Werner, C., Zwißler, B. (eds) Die Anästhesiologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54507-2_64

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  • DOI: https://doi.org/10.1007/978-3-662-54507-2_64

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