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Peri‐operative changes in plasma C3a and C5a concentrations in infants
Author(s) -
MIKAWA K.,
MAEKAWA N.,
IKEGAKI J.,
GOTO R.,
YAKU H.,
OBARA H.
Publication year - 1992
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.1992.tb00187.x
Subject(s) - medicine , fentanyl , halothane , anesthesia , perioperative , complement system , surgical stress , elective surgery , anesthesiology , immunology , immune system
Summary It is well known that complement activation plays a key role in the development of pulmonary insufficiency; it is also well known that cortisol suppresses complement activation. By measuring the plasma concentrations of C3a and C5a, we investigated peri‐operative changes in the activation of the complement system in 18 infants undergoing elective abdominal surgery. We also measured plasma cortisol concentrations to assess the peri‐operative relationship between complement activation and the stress produced by multiple peri‐operative factors following two anaesthetic techniques. Eighteen infants ranging in age from 1 to 11 months were randomly divided into two groups according to the anaesthetic technique used: Group 1 consisted of nine infants in whom general anaesthesia was maintained with halothane and nitrous oxide (N 2 O) in oxygen, while Group 2 consisted of nine infants in whom general anaesthesia was maintained with fentanyl and N 2 O in oxygen. Plasma C3a and C5a concentrations were higher in the fentanyl group than in the halothane group during the peri‐operative period. Plasma cortisol concentration, in contrast, was lower in the fentanyl group both during and after surgery. The post‐operative clinical course showed no significant intergroup differences between the two groups throughout the study. These observations suggest that the difference in peri‐operative complement activation between the halothane and the fentanyl groups may have been due, in part, to different peri‐operative stress responses. However, further studies are required to elucidate the precise causative mechanisms and the clinical implications of complement activation in infants.