Effects of anaesthesia on the inflammatory response to injury.

Curr Opin Anaesthesiol

St George's, University of London, Cranmer Terrace, London, UK.

Published: August 2011

AI Article Synopsis

  • The systemic inflammatory response is important for healing, but too much inflammation can lead to complications after surgery.
  • Recent research highlights how genetic differences influence inflammation levels, especially in cardiac surgery patients.
  • Potential treatments being explored include interleukin-1 receptor antagonists, glucocorticoids, systemic lidocaine for abdominal surgery, and a call for more studies on NSAIDs.

Article Abstract

Purpose Of Review: The systemic inflammatory response to injury is essential for wound healing and recovery in concert with other endocrinological, metabolic and immunological changes. However, recent studies suggest that a hyperinflammatory state is associated with adverse perioperative outcomes. Therefore interventions that modulate the inflammatory response, surgical, anaesthetic and pharmacological, may enhance recovery with fewer complications.

Recent Findings: Basic research on wound biology has shown the importance of genetic variability in determining the initial inflammatory response. Clinically, studies of cardiac surgery predominate in which genetic polymorphisms have been shown to result in a hyperinflammatory state.

Summary: The use of an interleukin-1 receptor antagonist to control wound pain and limit local inflammation is under consideration. The role of glucocorticoids in obtunding the inflammatory response to injury with improved outcome requires confirmation with better-quality trials. Systemic lidocaine is anti-inflammatory but is effective only in abdominal surgery. NSAIDs are neglected, despite their widespread clinical use and merit detailed investigation.

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Source
http://dx.doi.org/10.1097/ACO.0b013e328348729eDOI Listing

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