TABLE 1.
Influence of various anesthetics on immune function.
| Agent | Neutrophil | NK cell | Macrophage | T cell | B cell | Refs. |
| Volatile anesthetics | ||||||
| Sevoflurane | Inhibit N recruitment via inhibiting LFA-1; down-regulate PRRs, reduce inflammatory reaction, and inhibit release of MMP-9 from N | Reduce the cytotoxicity of NK | Preserve the function of macrophage in vitro experiment; | induce apoptosis of thymic T cells; Low-flow sevoflurane alleviates T cell suppression | reduce the number of peripheral blood lymphocytes and spleen B cells in mice | (9–11, 108–110) |
| Isoflurane | Inhibits the adhesion of neutrophils to human endothelial cells | Suppress activity of NK cells | Inhibit macrophage recruitment via inhibiting Mac-1; | induce apoptosis of thymic T cells, induce apoptosis of T lymphocyte, lower the rate of Th1/Th2; | induce apoptosis of B lymphocyte via activating IP3 | (11, 12, 108, 111, 112) |
| Intravenous anesthetics | ||||||
| Propofol | Inhibit the immune function of neutrophils; | Increase the activity of NK cells, reduce proinflammatory cytokines; no effect on NK; | Recruit macrophages to liver cancer cells; | increase the activity of CTL, but not affect the rate of Th1/Th2 | (14, 15, 108, 113, 114) | |
| Etomidate | reduce inflammatory response | No effect on NK cytotoxicity; | Maintain the level of CD4 + and CD8 + T cells, reduce immune suppression | (62) | ||
| Opioids | ||||||
| Morphine | Combine with the G-protein coupled μ receptor on the surface of immune cells, produce immune suppression; | Suppress activity of NK cells | downregulate the expression of TLR4 | block signal transduction of TCR, and inhibit its function | Attenuate B cell producing anti-tumor antibodies; | (19, 20, 115–117) |
| Fentany | Inhibit the activity of NK cells; | Inhibit macrophages | increase the number of CD4 + CD25 + Foxp3 + T to inhibit the cell immune system | Inhibit humoral immune system | (23, 25) | |
| Butorphanol tartrate | Inhibit generation of inflammatory factors | inhibit T-cell evolution | Activated KOR inhibit generation of antibodies, | (26) | ||
| Local anesthetics | ||||||
| Lidocaine | Lidocaine reduces neutrophil adhesion, producing anti-inflammatory effects | Increase activity of NK cells via releasing lytic granules | Decreased inflammatory cytokine expression in dendritic cells and macrophages | inhibition of Th1 differentiation | (32, 118) | |
| Bupivacaine | Inhibit NK cells with the concentration of infiltration anesthesia | (31) | ||||