Immunomodulatory effects of anesthetics in obese patients

Table 1 Clinical studies of effects of anesthesia on immune cells and outcomes in obese patients

Ref.	Population	Interventions	Comparison	Outcome
Abramo et al[120]	Morbidly obese patients undergoing laparoscopic gastric bypass (n = 30)	TIVA Sevoflurane anesthesia Xenon anesthesia	Serum levels of IL-6, IL-10, TNF-α, and NO before anesthesia, at the end of surgery, and 12 h after the end of surgery	At the end of surgery, IL-10 and TNF-α levels were lower in patients anesthetized with xenon than in those given sevoflurane or TIVA
Roussabrov et al[121]	Obese patients undergoing short-duration gastric or uterine surgery (n = 36)	Ketamine (IV) pre- induction compared with no ketamine before general anesthesia	Serum levels of IL-1β, IL-2, IL-6, TNF- α, lymphocyte proliferation, and NK cell cytotoxicity	Results to those of previous studies in lean patients: No change in inflammation or immune response (11 studies), suppressed immune response (9 studies), or enhanced immune responses (1 study)

Summary of results from clinical studies comparing inhalational and intravenous anesthetics according to population, intervention, comparison, and outcomes. IV: Intravenous; IL: Interleukin; TNF: Tumor necrosis factor; NK: Natural killer cells; NO: Nitric oxide; TIVA: Total intravenous anesthesia.