Neutrophil chemotaxis during and after general anesthesia and operation

The neutrophil granulocytes of 43 patients undergoing general anesthesia and operation were examined to determine if altered function occurs during these procedures. Neutrophil chemotaxis, random migration, and total and differential leukocyte counts were determined immediately before anesthesia; after 35 to 60 minutes of anesthesia but before operation; 60 minutes after initiation of operation; and 60 minutes after operation. Anesthetic agents included 1 to 3.5% enflurane, 0.5 to 2% halothane, or 0.5 to 1.1 mg/kg of morphine plus N2O-O2 (60:40). Neutrophil and total white blood cell counts were uninfluenced by any of the anesthetics; however, marked rises in both occurred during operation and persisted postoperatively after each of the anesthetic technics. Neutrophil chemotaxis was reduced an average of 36, 32, and 21%, respectively, by halothane, enflurane, and morphine before operation and 20, 10, and 5% intraoperatively. Preoperative reductions in chemotaxis were statistically significant after all anesthetics. However, only halothane produced a significant intraoperative reduction in chemotaxis. Postoperative neutrophil chemotaxis did not differ from control (preanesthesia) values after any of the anesthetics. Halothane and enflurane reduced leukocytic random migration before but not after operation. Morphine had no effect on random migration at any time. These data demonstrate that anesthesia impairs neutrophil function in man but that operation appears to reverse this depression.