Pulmonary Inflammatory Mediators After Sevoflurane Anaesthesia in Tobacco Smoking and Non-Smoking Patients

Purpose: Volatile anaesthetics modify pulmonary immune and inflammatory reactions per se and in smokers anaesthetics appear to suppress the immune and inflammatory responses. Our hypothesis was that a more reduced amount of inflammatory responses would be observed in the smoking patients than in the non-smoking patients during surgery under sevoflurane anaesthesia. Methods: We compared pulmonary inflammatory responses in 20 non-smokers and 9 smokers during prostatectomy under sevoflurane anaesthesia. Bronchoalveolar lavage (BAL) fluids were collected after anaesthesia induction and at the end of the surgery. Results: Non-smokers demonstrated higher BAL LTC4 concentrations than smokers postoperatively. Smokers had a tendency to have increased IL-6 and IL-8 concentrations after surgery whereas the opposite was observed in non-smokers, contradicting our hypothesis. Conclusion: Pulmonary inflammatory mediators differ slightly between smokers and non-smokers during surgery under sevoflurane anaesthesia. Most likely these mediators have minor relevance to the postoperative pulmonary complications in smokers.