Perbandingan Efek Sevofluran dengan Halotan terhadap Jumlah Neutrofil

Hafniana Hafniana, Hasanul Arifin

Abstract


Neutrofil berperan penting dalam respons imun nonspesifik. Penurunan nilai neutrofil dapat dipakai sebagai parameter sederhana untuk mengukur tingkat stres dan inflamasi sistemik. Penelitian ini bertujuan mengetahui efek agen inhalasi sevofluran dan halotan terhadap penurunan neutrofil. Penelitian ini merupakan uji klinis dengan acak tersamar buta ganda yang membandingkan efek sevofluran dengan halotan terhadap  jumlah neutrofil pada 36 pasien ASA I dan II yang menjalani operasi elektif dengan anestesi umum di RSUP Haji Adam Malik Medan periode September 2016. Pasien dibagi dua kelompok, yaitu kelompok yang mendapat agen inhalasi sevofluran dan kelompok yang mendapat inhalasi halotan. Jumlah neutrofil dihitung pada kedua kelompok pada saat sebelum operasi, setelah induksi, dan 90 menit setelah inhalasi. Jumlah neutrofil pada kedua kelompok tidak mengalami penurunan sebelum operasi dan setelah induksi (p>0,005), namun mengalami penurunan pada 90 menit setelah inhalasi (p<0,005) pada tiap-tiap kelompok, namun uji beda antara kelompok sevofluran dan halotan tidak bermakna pada tiga kali pengukuran.  Simpulan, tidak terdapat perbedaan antara sevofluran dan halotan terhadap penurunan jumlah neutrofil.

 

Comparison of  Sevoflurane and Halothane Effects on Neutrophil Counts

Neutrophil has an important role in non-spesific immune responses. The declining value of neutrophil can be used as a parameter to measure the level of stress and systemic inflammation. This study aimed to determine the effects of sevoflurane and halothane inhalation agents on the number of neutrophil. This was a double-blind randomized comparing the effects of sevoflurane and halothane on the number of neutrophil in 36 ASA 1 and II patients underwent elective surgery under general anesthesia at Haji Adam Malik Central General Hospital  Medan during September 2016. Patients were divided into two groups: the group that received sevoflurane inhalation and the group that received halothane inhalation. The number of neutrophils was counted in both groups before surgery, after induction, and 90 minutes after inhalation. Both groups did not experience a decrease in neutrophil counts before surgery and after induction (p>0.005), but suffered a decline in the number of neuthrophils 90 minutes after inhalation (p>0.005). The difference between the sevoflurane and halothane groups was not meaningful in the three times of measurement. In conclusion, there is no difference between sevoflurane and halothane terms of declined number of neutrophils. 


Keywords


Halotan, neutrofil, sevofluran

Full Text:

PDF

References


Omera MA. Do volatile inhalation anaesthetics modify the immune response in surgical patients. AJAIC. 2007;9:34–43.

Kurosawa S, Masato K. Anesthetics, immune cells and immune response. J Anaesth. 2008;22:263–77.

Stevenson GW, Hall SC, Rudnick S, Seleny FL, Stevenson HC. The effect of anaesthetic, agents on human immune response. Anaesthesiology. 2009;72(3):542–52.

Malech HL, Gallin JI. Current concepts: immunology neutrophils in human diseases. N Eng J Med. 2010;317(10):687–90.

Tyther R, Halligant M, Wang J, Redmond HP, Shorten G. Effects of chronic occupational exposure to anaesthetics gases on the rate of neutrophil apoptosis among anaesthetists. Eur J Anaesthesiol. 2009;19:604–8.

Tyther R, O’Brien J, Wang J, Redmond HP, Shorten G. Effect of sevoflurane on human neutrophil apoptosis. Eur J Anaesthesiol. 2010;20:111–5.

Morisaki H, Aoyoma Y, Shimada M, Ochiai R, Takeda J. Leucocyte distribution during sevoflurance anaesthesia. Br J Anaesth. 1997;80:502–3.

Shorten J. Potential adverse effect of volatile anaesthetic agents – immune function and chronic occupational exposure. Refresher Courses. Cork: Department of Anaesthesia Cork University Hospital Ireland; 2002.

Miwalko N. Inhibition of superoxide production and calcium mobilization in human neutrophils by halothane, enflurance, and isoflurance. Anaesthesiology. 1999;64:4–12.

Ahad B, Shah ZA, Mehrajuddin, Shah A, Salahuddin M. Effect of general anaesthesia and surgery on neutrophil phagocytic function. JK-Practioner. 2009;12(3):121–4.

Colucci DG, Pulg NR, Hernandez PR. Influence of anaesthetic drugs on immune respon: from inflammation to immunosuppression. OA Anaesthetics. 2013;1(3):21.




DOI: http://dx.doi.org/10.15851/jap.v5n3.1169

Refbacks

  • There are currently no refbacks.



 

This Journal indexed by:

               

 
Creative Commons License
JAP is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 


View My Stats