Imunomodulacijska djelovanja anestetika

master's thesis

• Title (english): Immunomodulatory effects of anesthetics
• Author: Helena Klasan
• Mentor: Ante Sekulić (mentor)
• Committee member: Slobodan Mihaljević (predsjednik povjerenstva)
• Committee member: Dinko Tonković (član povjerenstva)
• Committee member: Ante Sekulić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2021-09-25, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Cilj ovog rada je ponuditi trenutna saznanja o imunomodulacijskom djelovanju anestetika na imunosni sustav. Imunosni sustav tipično se dijeli na urođenu i adaptivnu imunost. Perioperativni imunosni odgovor uključuje širok spektar promjena u imunosti domaćina, a anestetici mogu modulirati i adaptivni i urođeni odgovor. Ovaj rad procjenjuje specifične efekte često korištenih inhalacijskih, intravenskih i lokalnih anestetika i uspoređuje ih na temelju utjecaja na dugoročni ishod. Iako je poznato da opća i regionalna anestezija uglavnom suprimiraju imunosni odgovor, različiti anestetici mogu uzrokovati različite učinke, tako da specifični učinak se može razlikovati. Imunosupresija može imati koristan efekt u ograničavanju lokalne i sistemne upale, no negativni učinak je veći rizik infekcije, tako da su potrebna dodatna istraživanja kako bi se istaknuli pozitivni učinci anestetika. Osim modulacije kirurškog procesa, anestetici čini se imaju utjecaj na tumorske procese i progresiju metastaza. Temeljeno na usporedbi regionalne i opće anestezije (intravenske i inhalacijske) u nedavnim istraživanjima, preporuka je korištenja regionalne anestezije u onkološkoj kirurgiji. Bitno je da anesteziolog pri planiranju perioperativne skrbi u obzir uzme i moguća imunomodulacijska djelovanja različitih anestetika i odluči se za primjenu odgovarajuće tehnike za bolji postoperativni ishod.

Abstract (english)

The aim of this thesis is to provide a systematic overview of literature regarding the effects of anaesthetics on immune system. The immune system is typically divided into innate and adaptive immunity. Perioperative immune response includes broad spectrum of alterations in host immunity and use of anaesthetic agents can modulate both adaptive and innate response.
This review evaluates specific effects of commonly used volatile, intravenous and local anaesthetic agents and compares different anaesthetic techniques based on long-term outcome. Although it is known that general and regional anaesthesia mostly suppress immune response, it is reported that different anaesthetic agents may induce different immune cell responses so their specific effect can vary. Immunosuppression can be beneficial in reducing local and systemic inflammation, but negative effect is higher infection risk, so further studies are needed to enhance protective effects of anaesthetic agents. Except the modulation of surgical response, the anaesthetic agents seem to affect cancer cell processes and metastatic progression. Based on comparison of regional and general anaesthesia (intravenous and inhalational) in recent studies, the recommendation is to use regional anaesthesia in oncological surgery. It is important for anaesthesiologists planning perioperative care to take in consideration possible immunomodulatory effects of different anaesthetics and to choose proper anaesthetic technique for better postoperative outcome.

• Keywords: imunost; anestetici; opća anestezija; regionalna anestezija; postoperativni ishod
• Keywords (english): immunity; anaesthetics; general anaesthesia; regional anaesthesia; postoperative outcome
• Language: croatian
• URN:NBN: urn:nbn:hr:105:615129
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-02-24 10:54:01