J Korean Med Sci.  2015 Oct;30(10):1503-1508. 10.3346/jkms.2015.30.10.1503.

Effect of Propofol and Desflurane on Immune Cell Populations in Breast Cancer Patients: A Randomized Trial

• Woo JH
• Baik HJ
• Kim CH
• Chung RK
• Kim DY
• Lee GY
• Chun EH

• KMID: 2344186
• DOI: http://doi.org/10.3346/jkms.2015.30.10.1503

Abstract

Several factors can affect the perioperative immune function. We evaluated the effect of propofol and desflurane anesthesia on the surgery-induced immune perturbation in patients undergoing breast cancer surgery. The patients were randomly assigned to receive propofol (n = 20) or desflurane (n = 20) anesthesia. The total and differential white blood cell counts were determined with lymphocyte subpopulations before and 1 hr after anesthesia induction and at 24 hr postoperatively. Plasma concentrations of interleukin (IL)-2 and IL-4 were also measured. Both propofol and desflurane anesthesia preserved the IL-2/IL-4 and CD4+/CD8+ T cell ratio. Leukocytes were lower in the propofol group than in the desflurane group at 1 hr after induction (median [quartiles], 4.98 [3.87-6.31] vs. 5.84 [5.18-7.94] 10(3)/microL) and 24 hr postoperatively (6.92 [5.54-6.86] vs. 7.62 [6.22-9.21] 10(3)/microL). NK cells significantly decreased 1 hr after induction in the propofol group (0.41 [0.34-0.53] to 0.25 [0.21-0.33] 10(3)/microL), but not in the desflurane group (0.33 [0.29-0.48] to 0.38 [0.30-0.56] 10(3)/microL). Our findings indicate that both propofol and desflurane anesthesia for breast cancer surgery induce a favorable immune response in terms of preservation of IL-2/IL-4 and CD4+/CD8+ T cell ratio in the perioperative period. With respect to leukocytes and NK cells, desflurane anesthesia is associated with less adverse immune responses than propofol anesthesia during surgery for breast cancer. (Clinical trial registration at https://cris.nih.go.kr/cris number: KCT0000939)

Keyword

Propofol; Desflurane; Immune System; Breast Neoplasms

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Anesthesia/adverse effects
Anesthetics, Inhalation/*therapeutic use
Anesthetics, Intravenous/*therapeutic use
Breast Neoplasms/immunology/*surgery
*CD4-CD8 Ratio
Female
Humans
Interleukin-2/blood
Interleukin-4/blood
Isoflurane/*analogs & derivatives/therapeutic use
Middle Aged
Postoperative Period
Propofol/*therapeutic use
Young Adult
Anesthetics, Inhalation
Anesthetics, Intravenous
Interleukin-2
Interleukin-4
Isoflurane
Propofol

Figure

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  Fig. 1 Study flow chart.

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