Comparative Study Of The Effect Of Some Inhalational Anaesthetic Acents On Polymorhonu clear Leucocyte Function In Normal And Innunocompromized Patiemnts

Initial resistance to microbial invasion is mediated primarily by polymorphonuclear leucocytes. The PMNLs cellular response to microbial invasion may be classified into chemotaxis, adherence, phagocytosis and intracellular kill ing. A disorder of any of these functions may allow microbial invasion to develop.Many normal functions of the immune system depressed after exposure to a combination of anaesthesia and surgery. Although it would appear that many of the immune changes that occure in surgical patients are primarily due to the effect of surgical trauma and endocrine response, it is important to assess any role of anaesthetic agents in altering leucocyte function. The inhibitory effect of anaesthesia on PMNLs functions may result not only in peri operative immunosupression, but if used in immunocompromized patients, may potentialy further compromize an already depressed host defence mechanism.This study was planned as an attempt to throw spot light upon effect of some inhalational anaesthetic agents on the PMNLs phagocytic function ,total and diffirentialleucocyte count in normal and immunocompromized patients.Sixty patients of both sexs were arranged into three groups, twenty patients each . Group I inhaled 0.5 % halothane with nitrous oxide and oxygen in a ratio of 60 : 40 % , group II inhaled 1.5 -2 % halothane and group III inhaled 0.8- 1.0 % isoflurane . Each main group subdivided into two main subgroups, subgroup A [normal patients] and subgroup B [immunocompromized patients] , ten patients each.The following parameters were studied:* Quantitative determination of PMNLs phagocytosis by flow cytometry.* Total and differential leucocyte count using automatic cell counter.The result were statistically analyezed and came into the following finding:There was a non significant depression of phagocytosis percentage in both subgroups of group I In groups II andIII there were a very high significant and significant depression of phagocytosis percentage respectively in their subgroups which returned back to its baseline by the first postoperative day.The induction of anaesthesia had no significant effect on the total leucocyte count and neutrophil count. Surgical trauma caused an increase in these counts which were statistically significant compared to control values in all groups. The highest counts were seen in the recovery period , which decreased on the first post operative day , but still significantly elevated compared to control values.The lymphocytic response showed no significant change during anaesthesia and surgery except in isoflurane group where there was a significant decrease of lymphocyte count in itssubgroups ,while the first postoperative day counts were as their baseline in all groups.No significant changes In the monocyte count were seen in all groups.