Abstract
The effects of anesthesia and surgery on neutrophil count, chemotaxis and neutrophil alkaline phosphatase (NAP) score were investigated in 10 patients who had elective spine surgery. Plasma levels of adrenaline, noradrenaline and cortisol were measured and correlations between hormonal levels and neutrophil count and function were assessed.
Neutrophil count started increasing after the initiation of surgery, reached the highest level at 3 hours after surgery, and decreased gradually toward preanesthetic level on 3rd postoperative day. The increase in band cell: segment cell ratio is prominent, whereas lymphocytes decreased significantly. Neutrophil chemotaxis and spontaneous migration were increased significantly from the end of operation to 1st postoperative day. NAP score, assumed to reflect the neutrophil phagocytic activity, lowered transiently during anesthesia, then increased 1.6 times more than preanesthetic level on 1st postoperative day. It was indicated that the increased cortisol release rather than adrenaline due to body r-esponse to surgical stress might induce neutrophilia, and that the elective spine surgery might not be deleterious to the neutrophil function.
Similar content being viewed by others
References
El-Maallem H, Fletcher J: Effects of surgery on neutrophil granulocyte function. Infect Immun 32:38–41, 1981
Van Dijk WC, Verbrugh HA, Van Rijswijk REN, Vos A, Verhoef J: Neutrophil function, serum opsonic activity, and delayed hypersensitivity in surgical patients. Surgery 92:21–29, 1982
Mollitt DL, Steele RW, Marmer DJ, Golladay ES, Costas S, Arkansas LR: Surgically induced immunologic alterations in the child. J Pediatr Surg 19:818–822, 1984
Duignan JP, Collins PB, Johnson AH, Bouchier-Hayes D: The association of impaired neutrophil chemotaxis with postoperative surgical sepsis. Br J Surg 73:238–240, 1986
Derbyshire DR, Smith G: Sympathoadrenal responses to anaesthesia and surgery. Br J Anaesth 56:725–739, 1984
Samuels AJ: Primary and secondary leucocyte changes following the intramuscular injection of epinephrine hydrochloride. J Clin Invest 30:941–947, 1951
Fauci AS, Dale DC, Balow JE: Glucocorticosteroid therapy: Mechanisms of action and clinical considerations. Ann Intern Med 84:304–315, 1976
Solomkin JS, Bauman MP, Nelson RD, Simmons RL: Neutrophils dysfunction during the course of intra-abdominal infection. Ann Surg 194:9–17, 1981
Moudgil GC, Pandya AR, Ludlow DJ: Influence of anaesthesia and surgery on neutrophil chemotaxis. Can Anaesth Soc J 28:232–238, 1981
Bardosi L, Tekeres M: Impaired metabolic activity of phagocytic cells after anaesthesia and surgery. Br J Anaesth 57:520–523, 1985
Hallman H, Farnebo L-O, Hamberger B, Jonsson G: A sensitive method for the determination of plasma catecholamines using liquid chromatography with electrochemical detection. Life Sci 23:1049–1052, 1978
Nelson RD, Quie PG, Simmons RL: Chemotaxis under agarose: A new and simple method for measuring chemotaxis and spontaneous migration of human polymorphonuclear leukocytes and monocytes. J Immunol 115:1650–1656, 1975
Kaplow LS: A histochemical procedure for localizing and evaluating leukocyte alkaline phosphatase activity in smears of blood and marrow. Blood 10:1023–1029, 1955
Brown FF III, Owens WD, Felts JA, Spitznagel EL Jr, Cryer PE: Plasma epinephrine and norepinephrine levels during anesthesia: Enflurane-N2O-O2 compared with Fentanyl-N2O-O2. Anesth Analg 61:366–370, 1982
Fehr J, Grossmann H-C: Disparity between circulating and marginated neutrophils: Evidence from studies on the granulocyte alkaline phosphatase, a marker of cell maturity. Am J Hematol 7:369–379, 1979
Marsh JC, Boggs DR: Leukocytes and hematopoietic stem cells, Sodeman’s pathologic physiology, Edited by Sodeman WA Jr, Sodeman TM. Philadelphia, WB Saunders, 1985, pp. 584–647
Stanley TH, Hill GE, Portas MR, Hogan NA, Hill HR: Neutrophil chemotaxis during and after general anesthesia and operation. Anesth Analg 55:668–673, 1976
Repo H, Jokipii AMM, Marjattaleirisalo, Kosunen TU: Leucocyte motility in the newborn: determination of spontaneous movement is essential in the in vitro assessment of neutrophil chemotaxis. Clin Exp Immunol 40:620–626, 1980
Hindocha PJ, Hedges SB, Wood CBS: Assessment of neutrophil chemotaxis and random migration in children and adults: Comparison between filter and agarose techniques. Int Arch Allergy appl Immunol 76:116–119, 1985
Frei PC, Hermanovicz A, Pecoud A: Chemotaxis of human polymorphonuclears in vitro. V. Role of the nonsegmented neutrophils and of the experimental conditions in the impairment of chemotaxis observed during bacterial infections. J Lab Clin Med 92:577–583, 1978
Cohen MR, Pickar D, Dubois M: The role of the endogenous opioid system in the human stress response. Psychiatr Clin North Am 6:457–471, 1983
Hill HR, Estensen RD, Quie PG, Hogan NA, Goldberg ND: Modulation of human. neutrophil chemotactic responses by cyclic 3′, 5′-guanosine monophosphate and cyclic 3′, 5′-denosine monophosphate. Metabolism 24:447–456, 1975
Bergman MJ, Guerrant RL, Murad F, Richardson SH, Weaver D, Mandell GL: Interaction of polymorphonuclear neutrophils with escherichia coli. J Clin Invest 61:227–234, 1978
Stevenson RD, Gray AC, Lucie NP: Stimulation of capillary tube polymorph migration: an indirect glucocorticoid effect on microtubular function. Clin Exp Immunol 33:478–485, 1978
Sullivan GW, Patselas TN, Redick JA, Mandell GL: Enhancement of chemotaxis and protection of mice from infection. Trans Assoc Am Physicians 97:337–345, 1984
Van Oss CJ: Phagocytosis: An overview. Methods EnzymoI 132:3–15, 1986
Roth JA, Kaeberle ML, Hsu WH: Effects of ACTH administration on bovine polymorphonuclear leukocyte function and lymphocyte blastogenesis. Am J Vet Res 43:412–416, 1982
Guelfi JF, Courdouhji MK, Alvinerie M, Toutain PL: In vivo and in vitro effects of three glucocorticoids on blood leukocyte chemotaxis in the dog. Vet Immunol Immunopathol 10:245–252, 1985
Simkins CO, Dickey CA, Fink MP: Human neutrophil migration is enhanced by betaendorphin. Life Sci 34:2251–2255, 1984
Merkiel K, Prokopowicz J, Krawczuk J: Neutrophil alkaline phosphatase activity in patients with neoplasma during surgical treatment. Neoplasma 28:593–597, 1981
Pedersen B, Hayhoe FGJ: Relation between phagocytic activity and alkaline phosphatase content of neutrophils in chronic myeloid leukaemia. Br J Haematol 21:257–260, 1971
Bondue H, Machin D, Stryckmans PA: The leucocyte alkaline phosphatase activity in mature neutrophils of different ages. Scand J Haematol 24:51–56, 1980
Scott CS, Cordingley RJ, Roberts BE, Bynoe AG, Hough D: Relation of neutrophil alkaline phosphatase activity to Fc-IgG receptor development in human blood and bone marrow. J Clin Pathol 35:967–971, 1982
Author information
Authors and Affiliations
About this article
Cite this article
Tabuchi, Y., Shinka, S. & Ishida, H. The effects of anesthesia and surgery on count and function of neutrophils. J Anesth 3, 123–131 (1989). https://doi.org/10.1007/s0054090030123
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s0054090030123