Mucosal host defence response to hysterectomy assessed by saliva analyses: A comparison of propofol and isoflurane anaesthesia

Abstract

We compared the effects of propofol-based (n = 15) and isoflurane-based anaesthesia (n = 15) on mucous host defences by measuring the salivary flow and the concentrations/activities of salivary total protein and amylase, and of salivary immunological (IgA, IgG and IgM) and nonimmunoglobulin defence factors (lysozyme, myeloperoxidase, total salivary peroxidase and thiocyanate) in patients undergoing elective abdominal hysterectomy. The saliva samples were collected pre-operatively and on the first and fourth postoperative days. The concentrations of salivary protein and amylase as well as those of immunological and nonimmunological defence factors were significantly increased on the first postoperative day. The secretion rate of total protein, amylase, lysozyme, total peroxidase, thiocyanate and IgG, however, decreased owing to a marked decrease in the salivary flow but no alterations were found in the secretion rate of myeloperoxidase, IgA and IgM. The changes were similar in both groups. These findings show that nonimmunological oral mucous host defences are altered after major surgery, but immunoglobulin responses are better maintained. Both types of anaesthesia induce marked short-term hyposalivation.