Propofol has been reported to produce a dose-dependent inhibition of phagocytosis and
superoxide anion production during the respiratory burst (RB) of polymorphonuclear cells (PMNs) in vitro. In this randomized, blinded study, these two parameters were compared during
propofol or
isoflurane anaesthesia in patients undergoing elective interventional embolization of cerebral arterio-venous malformations. Anaesthesia was performed with continuous intravenous
propofol 6-8 mg kg-1 h-1 (n = 15) or
isoflurane 0.8-1.0% end tidal (n = 15). Heparinized blood was drawn before, and 2 and 4 h after induction of anaesthesia. The RB in isolated leucocytes was measured with the
fluorescent dye rhodamine after ex vivo induction by Escherichia coli or tumour
necrosis factor alpha/N-formyl-methionyl-
leucylphenylalanine (
TNF-alpha/FMLP). Phagocytosis was carried out in whole blood after incubation with
fluorescein isothiocyanate (
FITC)-labelled, opsonized E. coli and also measured with a flow cytometer. The two groups were similar in terms of biometric data and haemodynamic responsiveness. After 4 h of
propofol or
isoflurane anesthesia, the mean (SD) phagocytosis of E. coli was 93.2% (7.0%) and 94.3% (9.2%), respectively, of that before anaesthesia. The percentage of PMN with RB activity following
TNF-alpha/FMLP stimulation was significantly reduced after 2 h (80.9% (24.2%); P < 0.05) and 4 h (53.7% (27.3); P < 0.05) of anaesthesia with
propofol compared with the values before induction. This effect of
propofol anaesthesia was significantly different from the effect of
isoflurane anaesthesia. In contrast to published in vitro results, 4 h of anaesthesia with
propofol did not reduce the phagocytotic capacity of human blood PMN more than
isoflurane anaesthesia.