ANESTHETICS MODULATE TUMOR-NECROSIS-FACTOR-ALPHA - EFFECTS OF L-CARNITINE SUPPLEMENTATION IN SURGICAL PATIENTS - PRELIMINARY-RESULTS

BOTH anaesthetics and surgical trauma could strongly affect the production of tumour necrosis factor alpha (TNF alpha). During in vitro experiments the authors found that anaesthetics modulate the production of TNF alpha by peripheral blood mononuclear cells. Notably, Pentothal strongly increased the production of the cytokine as compared to both lipopolysacchride treated and control mononuclear cells, whereas in supernatants from Leptofen driven mononuclear cells TNF alpha was strongly reduced. On the other hand, Pavulon did not significantly affect the cytokine production. In the in vivo study, in an attempt to ameliorate the metabolic response to surgical trauma, L-carnitine was administered to 20 surgical patients, then the circulating TNF alpha was measured. The results indicate that the levels of circulating TNF alpha were strongly increased following surgery and that L-carnitine administration resulted in a strong reduction of TNF alpha. Thus, the data suggest that L-carnitine could be helpful in protecting surgical patients against dysmetabolism dependent on dysregulated production of TNF alpha.