Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--12. Effects on plasma complement and immunoglobulin concentrations
Hashimoto, H.; Araki, I.; Sato, T.; Takagi, Y.; Hashimoto, Y.; Ishihara, H.; Matsuki, A.
Masui. Japanese Journal of Anesthesiology 40(12): 1838-1842
1991
ISSN/ISBN: 0021-4892 PMID: 1770576 Document Number: 368195
Complements and immunoglobulins in the plasma are the important humoral factors to maintain immunity. As there is no study on immune response to total intravenous anesthesia with droperidol, fentanyl and ketamine (DFK), twelve patients who underwent abdominal, neck dissection, or plastic surgery were studied to determine plasma concentrations of complements and immunoglobulins. In five patients of isoflurane group, anesthesia was induced with intravenous thiopental 5 mg.kg-1 and succinylcholine 0.8-1 mg.kg-1 and maintained with 1-2% isoflurane in nitrous oxide (50%) and oxygen (50%). The remaining seven patients of the DFK group received intravenous droperidol 0.25 mg.kg-1, fentanyl 1-2 micrograms.kg-1, ketamine 1-1.5 mg.kg-1 and succinylcholine 0.8-1 mg.kg-1 for the induction of anesthesia, and then they were given a total dose of fentanyl 5-15 micrograms.kg-1, ketamine 2 mg.kg-1.hr-1 and oxygen (30%) for the maintenance of anesthesia. Vecuronium was given intravenously as needed. Lactated Ringer's solution was used for intraoperative fluid replacement. A total of 40 ml of arterial blood was drawn on four occasions, just before the induction of anesthesia, at the recovery from anesthesia, on the third and tenth post-operative days. Plasma concentrations of complements (C3.C4) and immunoglobulins (IgG.IgA.IgM.IgD) were measured by immuno-turbidimetry. C3 concentrations in the plasma decreased significantly when the patients recovered from anesthesia, but they increased significantly on the third and tenth post-operative days in the isoflurane group. In the DFK group, they increased significantly on the tenth post-operative day only. No significant difference in the C3 concentrations was detected between two groups at any time of measurement.