Fever as a defense system of the body to surgical stress-Its physiological investigation and relationship to anesthesia

无论外科医生如何严格地无菌操作，术后第1天90%的<st>患者有明显的发热。发现术后发热与IL-1（α，β）、IL-6、TNF α、INF α、MIP-1（α，β）等细胞因子密切相关。手术应激也可引起多种细胞因子的释放，其中IL-6是对手术应激强度和麻醉深度敏感的细胞因子。我们还研究了志愿者，每个人静脉注射50，000 IU/kg的白细胞介素-2，2小时后注射100，000 IU/kg。志愿者被随机分配到三个剂量的地氟烷诱导麻醉：（1）0.0最小肺泡浓度（MAC ;对照），（2）0.6 MAC和（3）1.0 MAC。地氟烷诱导麻醉产生剂量依赖性降低的综合和峰值核心温度后，管理热原，1.0 MAC基本上消除发热。因此，麻醉剂诱导的热原反应抑制是手术期间发热是对炎症不一致的临床反应的原因之一。

No matter how strictly the surgeons perform operation aseptically, 90% of the 1^<st> post-operative-day patients have significant fever. We found these post-operative fever had tight relationship with cytokines such as IL-1 (alpha, beta), IL-6, TNFalpha, INFalpha, MIP-1(alpha, beta). Surgical stress also provoke the release of various types of cytokines, especially IL-6 is known as sensitive cytokines to intensity of surgical stress and depth of anesthesia.In this study, we investigated the interactions between fever and plasma cytokines changes during surgery and post-operatively. We also studied volunteers, each was given an intravenous injection of 50,000 IU/kg of interleukin-2 followed 2 hours later by 100,000 IU/kg. Volunteers were assigned randomly to three doses of desflurane to induce anesthesia : (1) 0.0 minimum alveolar concentration (MAC ; control), (2) 0.6 MAC and (3) 1.0 MAC.Desflurane-induced anesthesia produced a dose-dependent decrease in integrated and peak core temperatures after administration for pyrogen, with 1.0 MAC essentially obliterating fever. Anesthetic-induced inhibition of the pyrogenic response is therefore one reason that fever is an inconsistent clinical response to inflammation during surgery.