Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Special Article

Plasma levels of interleukin-10 and nitric oxide in response to two different desflurane anesthesia flow rates

Níveis plasmáticos de interleucina-10 e óxido nítrico em resposta a duas taxas de fluxo em anestesia com desflurano

Dilek Kalayci; Bayazit Dikmen; Murat Kaçmaz; Vildan Taspinar; Dilsen Örnek; Özlem Turan

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OBJECTIVE: This study investigated interleukin-10 and nitric oxide plasma levels following surgery to determine whether there is a correlation between these two variables and if different desflurane anesthesia flow rates influence nitric oxide and interleukin-10 concentrations in circulation. MATERIALS AND METHODS: Forty patients between 18 and 70 years and ASA I-II physical status who were scheduled to undergo thyroidectomy were enrolled in the study. INTERVENTIONS: Patients were allocated into two groups to receive two different desflurane anesthesia flow rates: high flow (Group HF) and low flow (Group LF). MEASUREMENTS: Blood samples were drawn at the beginning (t 0) and end (t 1) of the operation and after 24 h (t 2). Plasma interleukin-10 and nitric oxide levels were measured using an enzyme-linked-immunosorbent assay and a Griess reagents kit, respectively. Hemodynamic and respiratory parameters were assessed. RESULTS: There was no statistically significant difference between the two groups with regard to interleukin-10 levels at the times of measurement. Interleukin-10 levels were increased equally in both groups at times t 1 and t 2 compared with preoperative concentrations. For both groups, nitric oxide circulating concentrations were significantly reduced at times t 1 and t 2 compared with preoperative concentrations. However, the nitric oxide value was lower for Group HF compared to Group LF at t 2. No correlation was found between the IL-10 and nitric oxide levels. CONCLUSION: Clinical usage of two different flow anesthesia forms with desflurane may increase interleukin-10 levels both in Group HF and Group LF; nitric oxide levels circulating concentrations were significantly reduced at times t 1 and t 2 compared with preoperative concentrations; however, at 24 h postoperatively they were higher in Group LF compared to Group HF. No correlation was detected between interleukin-10 and nitric oxide levels.


General anesthesia, Interleukin, Surgery, Nitricoxide, Desflurane


OBJETIVO: este estudo investigou os níveis plasmáticos de interleucina-10 e óxido nítrico após cirurgia para determinar se há correlação entre essas duas variáveis e se diferentes taxas de fluxo de anestesia com desflurano influenciam as concentrações de interleucina-10 e óxido nítrico na circulação. MATERIAIS E MÉTODOS: quarenta pacientes, entre 18 e 70 anos de idade, estado físico ASA I-II, programados para tireoidectomia foram incluídos no estudo. INTERVENÇÕES: os pacientes foram divididos em dois grupos para receber dois fluxos diferentes de anestesia com desflurano: fluxo alto (Grupo FA) e fluxo baixo (Grupo FB). MENSURAÇÕES: amostras de sangue foram colhidas no início (t 0 ) e final (t 1 ) da cirurgia e após 24 h (t 2 ). Os níveis plasmáticos de interleucina-10 e óxido nítrico foram medidos usando um ensaio imunossorvente ligado à enzima um estojo de reagentes de Griess, respectivamente. Os parâmetros hemodinâmicos e respiratórios foram avaliados. RESULTADOS: não houve diferença estatisticamente significante entre os dois grupos em relação aos níveis de interleucina-10 níveis nos tempos de medição. Os níveis de interleucina-10 aumentaram igualmente em ambos os grupos nos tempos t 1 e t 2 em comparação com as concentrações no pré-operatório. Em ambos os grupos, as concentrações circulantes de óxido nítrico estavam significativamente reduzidas nos tempos t 1 e t 2 em comparação com as concentrações no pré-operatório. No entanto, o valor de óxido nítrico foi menor no Grupo FA que no Grupo FB no t 2 . Não houve correlação entre os níveis de IL-10 e óxido nítrico. CONCLUSÃO: o uso clínico de dois fluxos diferentes em anestesia com desflurano pode aumentar os níveis de interleucina-10 tanto no Grupo FA quanto no Grupo FB; os níveis das concentrações circulantes de óxido nítrico estavam significativamente reduzidos nos tempos t 1 e t 2 em cmparação com as concentrações no pré-operatório; contudo, 24 h após a cirurgia, esses níveis estavam maiores no Grupo FB em relação ao Grupo FA. Não foi detectada correlação entre os níveis de interleucina-10 e óxido nítrico.


Anestesia geral, Interleucina, Cirurgia, Óxido nítrico, Desflurano


Stevenson GW, Hall SC, Rudnick S. The effect of anaes- thetic agents on the human immune response. Anaesthesiology.. ;72:542-552.

Salo M. Effects of anaesthesia and surgery on the immune response. Acta Anaesthesiol Scand.. ;36:201-220.

Baykal Y, Karaayvaz M, Kutlu M. Med Sci.. ;18:77-83.

Crozier TA, Müller JE, Quittkat D. Effect of anaesthesia on the cytokine responses to abdominal surgery. Br J Anaesth.. ;72:426.

Pirttkangas CO, Salo M, Mansikka M. The influence of anaesthetic technique upon the immune response to hys- terectomy: a comparison of propofol infusion and isoflurane. Anaesthesia.. ;50:1061-1056.

Boost AK, Hofstetter C, Flondor M. Desflurane differen- tially affects the release of proinflammatory cytokines in plasma and bronchoalveolar fluid of endotoxemic rats. Int J Mol Med.. ;17:1139-1144.

Delogu G, Antonucci A, Signore M. Plasma levels of IL-10 and nitric oxide under two different anaesthesia regimens. Eur J Anaesth.. ;22:466-462.

Tsuei BJ, Bernard AC, Shane MD. Surgery induces human mononuclear cell arginase I expression. J Trauma.. ;51:497-502.

Galley H, Nelson LR, Webster NR. Anaesthetic agent decreases the activity of nitric oxide synthase from human polymorphonu- clear leucocytes. Br J Anaesth.. ;75:329-326.

Galley HF. Anaesthesia and the nitric oxide-cyclic GMP pathway in the central nervous system. Br J Anaesth.. ;84:143-141.

Tschaikowsky K, Ritter J, Schroppel K. Volatile anesthetics differentially affect immunostimulated expression of inducible nitric oxide synthase. Anesthesiology.. ;92:1102-1093.

Kelbel I, Weiss M. Anaesthetics and immune function. Curr Opin Anaesthesiol.. ;14:685-769.

Moudgil GC. Effect or premedicants, intravenous anaesthetic agents an local anaesthetics on phagocytosis in vitro. Can Anaesth Soc J.. ;28:597-602.

Brand JM, Kirchner H, Poppe C. The effects of general anesthesis on human peripheral immune cell distri- bution and cytokine production. Clin Immunol Immunopathol.. ;83:194-190.

Matsuoka H, Kurusawa S, Horunouchi T. Inhalation anes- thetics induce apoptosis in normal peripheral lymphocytes in vitro. Anesthesiology.. ;95:1472-1467.

Giraud O, Seince PF, Rolland C. Halothane reduces the early lipopolysaccharide-induced lung inflammation in mechanically ventilated rats. Am J Respir Crit Care Med.. ;162:2278-2286.

Goto Y, Ho SL, McAdoo J. General versus regional anaes- thesia for cataract surgery: effects on neutrophil apoptosis and postoperative proinflammatory state. Eur J Anaesthesiol.. ;17:474-480.

Schneemilch CE, Hachenberg T, Ansorge S. Effects of dif- ferent anaesthetic agents on immune cell function in vitro. Eur J Anaesthesiol.. ;22:623-616.

Bahadır B, Ba¸sgül E, C¸eliker V. Halotan, ˙Izofluran ve Sevofluran anestezilerinin immune yanıta etkisi. Anestezi Der- gisi.. ;11:260-264.

Kotani T, Hashimoto H, Sessler DI. Intraoperative mod- ulation of alveolar macrophage function during isoflurane and propofol anesthesia. Anesthesiology.. ;89:1130-1125.

Mitsuhata H, Shimizu R, Yokoyama MM. Suppressive effects of volatile anesthetics on cytokine release in human periph- eral blood mononuclear cells. Int J Immunopharmacol.. ;17:534-529.

Koksal GM, Sayilgan C, Gungor G. Effects of sevoflurane and desflurane on cytokine response during tympanaoplasty surgery. Acta Anaesthesiol Scand.. ;49:839-835.

Schilling T, Kozian A, Kretzschmar M. Effects of propo- fol and desflurane anaesthesia on the alveolar inflammatory response to one-lung ventilation. Br J Anaesth.. ;99:375-368.

Schneemilch CE, Hachenberg T, Ansorge S. Effect of 2 anesthetic techniques on the postoperative pro- inflammatory and anti inflammatory cytokine response and cel- lular immune function to minor surgery. J Clin Anesth.. ;17:527-517.

Blerkman D, Jones MV, Harrison NL. The effects of four general anesthetics on intracellular [Ca] in cultured rat hippocampal neurons. Neuropharmacology.. ;34:541-551.

Ochoa JB, Bernard AC, Mystry SK. Trauma increases extra- hepatic arginase activity. Surgery.. ;127:419-426.

Johns RA, Moscick JC, Difazio CA. Nitric oxide synthase inhibitor dose-dependently and reversibly reduces the threshold for halothane anaesthesia. A role for nitric oxide in mediating con- sciousness?. Anesthesiology.. ;77:784-779.

Kato M, Honda I, Suziki H. Interleukin-10 production during upper abdominal surgery. J Clin Anaesth.. ;10:188-184.

Davies MG, Fulton GC, Hagen PO. Clinical biology of nitric oxide. Br J Surg.. ;82:1598-1610.

Fujioka S, Mizumoto K, Okada K. A decreased serum concen- tration of nitrite/nitrate correlates with an increased plasma concentration of lactate during and after major surgery. Surg Today.. ;30:874-871.

Oudonhoven IM, Klaasen HL, lapre JA. Nitric oxide-derived urinary nitrate as a marker intestinal bacterial translocation in rats. Gastroenterology.. ;107:47-53.

Komarov AM, Reddy MN. Effect of septic shock on nitrate, free aminoacids, and urea in murine plasma and urine. Clin Biochem.. ;31:111-107.

Gunnett CA, Chu Y, Heistad DD. Vascular effects of LPS in mice deficient in expression of the gene for inducible nitric oxide synthase. Am J Physiol.. ;275:H416-H421.

Galley HF, Le Cras AE, Logan SD. Differential nitric oxide synthase activity, cofactor availability and cGMP accumulation in the central nervous system during anaesthesia. Br J Anaesth.. ;86:388-394.

Nakamura K, Terasako K, Toda H. Mechanisms of inhibition of endothelium-dependent relexation by halothane, isoflurane, and sevoflurane. Can J Anaesth.. ;41:346-340.

Pearce RA, Stringer JL, Lothman EW. Effect of volatile anesthetics on synaptic transmission in the hippocampus. Anes- thesiology.. ;71:591-598.

Yamamoto T, Shimoyama N, Mizuguchi T. Nitric oxide synthase inhibitor blocks spinal sensitization induced by formalin injec- tion into the rat paw. Anesth Analg.. ;77:890-886.

Muldoon SM, Hart JL, Bowen KA. Attenuation of endothelium-mediated vasodilatation by halothane. Anesthesi- ology.. ;68:31-37.

Uggeri MJ, Proctor GJ, Johns RA. Halothane, enflurane, and isoflurane attenuate both receptor and non-receptor medi- ated EDRF production in rat thoracic aorta. Anesthesiology.. ;76:1017-1012.

Blaise GA. Effect of volatile anesthetic agents on endothelium dependent relaxation. Mechanisms of anesthetic action in skeletal, cardiac, and smooth muscle. Advances in experimental medicine and biology, vol. 301. :235-229.

Greenblatt EP, Loeb AL, Longnecker DE. Endothelium dependent circulatory control a mechanism for the differing peripheral vascular effects of isoflurane versus halothane. Anesthesiology.. ;77:1185-1178.

Wei HM, Weiss HR, Sinha AK. Effects of nitric oxide syn- thase inhibition on regional cerebral blood flow and vascular resistance in conscious and isoflurane anesthetized rats. Anesth Analg.. ;77:880-885.

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