Intraoperative Thermostasis Protects Respiratory Burst Function Of Polymorphonuclear Neutrophils

ObjectiveTo investigate the influence of intraoperative thermostasis over respiratory burst (RB) of polymorphonuclear neutrophils (PMNs). Methods32 ASAI~III patients scheduled for elective thoracic pulmonary lobectomy under general anesthesia, were enrolled and randomized into two groups: control (C) group(n=16) and warming (W) group (n=16). In both groups, patients were covered with surgical drapes. In the warming group, patients were additionally warmed by force-air warming system and fluid warming device since admission to operation room. Anesthesia was induced with fentanyl, midazalom and propofol. Endotracheal intubation was facilitated by administration of rocuronium. Anesthesia was maintained with nitrous oxide, isoflurane and other agents if necessary. Core and peripheral temperatures were recorded at specific time points such as arrival, post-intubation, incision and every 30 minutes intraoperatively. Blood samples for analysis of complete blood count and reactive oxygen species (ROS) were obtained before anesthesia, intraoperatively and at the termination of surgery. Results1. Leukocyte count markedly increased intraoperatively and postoperatively in both groups. PMNs count remarkably increased intraoperatively and postoperatively in group C, while increased postoperatively in group W.2. PMA induced an extreme release of ROS, active warming might have an addictive effect on it.3. Without stimulus, intraoperative ROS generation of PMNs in group C significantly reduced. Intraoperative warming could counteract ROS decrease caused by surgery, anesthesia and hypothermia.Conclusions1. Perioperative thermostasis can be achieved by active warming strategies.