How analgesia-sedation alters monocyte mCD14 and HLA-DR levels in patients undergoing cerebral angiography?

Turk Neurosurg. 2013;23(6):791-5. doi: 10.5137/1019-5149.JTN.8218-13.0.

Abstract

Aim: This study aims to evaluate how analgesia-sedation causes alterations of HLA-DR and cytokines (IL-10 and IL-6) in patients undergoing cerebral angiography for several cerebral vascular diseases.

Material and methods: This study includes 41 males who underwent cerebral angiography. The study sample was divided into two: Group I had 7 patients who did not receive and group II had 34 patients who received analgesia-sedation before cerebral angiography. A venous blood sample was collected before and after cerebral angiography.

Results: Analgesia-sedation caused significant increase CD4+ and CD19 T lymphocytes (p < 0.001) but group I showed significant increase in CD40, CD154, and MHC-II levels (p < 0.001) after cerebral angiography.

Conclusion: We suggest that the effects of fentanyl and midazolam on the immune response are the reflection of the effects by the monocyte, mHLA-DR expression. In the future, depending on the immunological status of the patients, different anesthetic applications including the new anesthetic agents that will be able to decrease immune system suppression will be required.

MeSH terms

  • Adult
  • Aged
  • Analgesia / adverse effects*
  • Analgesics, Opioid / adverse effects
  • Angiography, Digital Subtraction / adverse effects*
  • Angiography, Digital Subtraction / methods
  • Antigens, CD19 / metabolism
  • CD4-Positive T-Lymphocytes / drug effects
  • Cerebral Angiography / adverse effects*
  • Cerebral Angiography / methods
  • Conscious Sedation / adverse effects*
  • Female
  • Fentanyl / adverse effects
  • HLA-DR Antigens / metabolism*
  • Humans
  • Hypnotics and Sedatives / adverse effects
  • Interleukin-10 / metabolism
  • Interleukin-6 / metabolism
  • Lipopolysaccharide Receptors / metabolism*
  • Lymphocyte Count
  • Male
  • Midazolam / adverse effects
  • Middle Aged
  • Monocytes / metabolism*

Substances

  • Analgesics, Opioid
  • Antigens, CD19
  • HLA-DR Antigens
  • Hypnotics and Sedatives
  • Interleukin-6
  • Lipopolysaccharide Receptors
  • Interleukin-10
  • Midazolam
  • Fentanyl