Monocyte Subsets Altered by Anesthesia

Neuraxial Versus General Anesthesia for Total Knee Replacement Surgery - Are There Different Effects on the Immune System?

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT03431532

Enrollment

Registered

2018-02-13

Start date

2013-02-01

Completion date

2015-03-01

Last updated

2022-05-11

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

General Anesthesia, Immune Function, Regional Anesthesia

Keywords

anesthesia, general anesthesia, neuraxial anesthesia, monocyte funtion, CD 14, HLA-DR, Interleukines

Brief summary

The impact of different anesthetic techniques on the immune system remains unclear. Aim of this ex vivo / in vitro study was to determine the effects of general and neuraxial anesthesia on monocyte subset alteration and the release of prototypical pro- and anti-inflammatory cytokines. Twenty patients undergoing total knee replacement surgery were randomly assigned to receive either general anesthesia (ITN) or combined spinal/epidural anesthesia (CSE). CD14 and HLA-DR expression patterns on monocytes and intracellular TNF-alpha production were quantified via flow cytometry. TNF-α and IL-10 release were measured via enzyme linked immunosorbent assay (ELISA).

Detailed description

Numerous of factors affect the immunological response during surgery. Despite intensive research, the impact of different anesthetic techniques on the immune system remains unclear. Aim of this ex vivo / in vitro study was to determine the effects of general and neuraxial anesthesia on monocyte subset alteration and the release of prototypical pro- and anti-inflammatory cytokines. Twenty patients undergoing total knee replacement surgery were randomly assigned to receive either general anesthesia (ITN) or combined spinal/epidural anesthesia (CSE). Samples of venous blood were taken from the patients before and after induction of anesthesia, immediately, 6 hours, 24 hours, and 48 hours after surgery. All blood samples were incubated in presence or absence of LPS (lipopolysaccharide; 1 µg/ml) for 24 hours. CD14 and HLA-DR expression patterns on monocytes and intracellular TNF-alpha production were quantified via flow cytometry. TNF-α and IL-10 release were measured via enzyme linked immunosorbent assay (ELISA).

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

OTHER

Eligibility

Sex/Gender

MALE

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Total knee replacement surgery * 18 years or older

Exclusion criteria

* clinical signs of infection, * neoplasia * treatment with immunomodulatory agents * any kind of immune mediated disease.

Design outcomes

Primary

Measure	Time frame	Description
CD 14 and HLA-DR Expression Patterns on monocytes	1 year	CD 14 and HLA-DR Expression Patterns on monocytes in whole blood culture assay

Secondary

Measure	Time frame	Description
Intracellular TNF-alpha production	1 year	Intracellular TNF-alpha production in whole blood culture assay
TNF-alpha and IL-10 release	1 year	TNF-alpha and IL-10 release in whole blood culture assay

Countries

Germany

Outcome results