Effect of Enflurane, Isoflurane, and Nitrous Oxide on the Microbicidal Activity of Human Polymorphonuclear Leukocytes

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Abstract
The effect of enflurane and isoflurane with and without N2O [anesthetics] on human polymorphonuclear leukocyte (PMNL) microbicidal function was studied. Bacterial killing was determined using a standard pour-plate technique and by oxidative activity as measured by chemiluminescence (CL). No killing of Escherichia coli, Klebsiella pneumoniae or Staphylococcus aureus was seen at bacterial:PMNL ratios of 1 or 10:1 with either enflurane or isoflurane at concentrations greater than normally used (3%). At a clinically relevant concentration of 2%, a significant inhibition of bacterial killing was observed with enflurane but not isoflurane at a bacteria:PMNL ratio of 100:1. The CL response was also decreased significantly (28% inhibition) by 2% enflurane. N2O 70% plus O2 30% had no effect on bactericidal activity or chemiluminescence alone or in combination with enflurane or isoflurane. The inhibition of bacterial killing and CL following enflurane exposure could be reversed by exposing the enflurane treated PMNL to air for 30 min. Enflurane is apparently able to inhibit PMNL microbicidal challenge or stimulus. This inhibition is temporal and only occurs during enflurane exposure.