en
Scientific article
Review
English

Influence of anesthesia on immune responses and its effect on vaccination in children: review of evidence

Published inPaediatric anaesthesia, vol. 17, no. 5, p. 410-420
Publication date2007
Abstract

Anesthesia and surgery exert immunomodulatory effects and some authors argue that they may exert additive or synergistic influences on vaccine efficacy and safety. Alternatively, inflammatory responses and fever elicited by vaccines may interfere with the postoperative course. There is a lack of consensus approach among anesthesiologists to the theoretical risk of anesthesia and vaccination. Few studies have assessed the influence of anesthesia and surgery on pediatric vaccine responses. We have undertaken an extensive review of articles published in English between 1970 and 2006 meeting the criteria: measurement of immune parameters following general anesthesia in children. By searching the major medical databases (OVID Medline, PubMed, ISI Web of Science) and references cited in the articles themselves, among 277 articles obtained none examined directly the influence of anesthesia/surgery on vaccine responses. Only 16 original reports assessed the influence of several anesthetic agents on various markers of immunity including lymphocyte numbers and functions. These results are reinterpreted here in view of our current understanding of the immune mechanisms underlying vaccine efficacy and adverse events. We conclude that the immunomodulatory influence of anesthesia during elective surgery is both minor and transient (around 48 h) and that the current evidence does not provide any contraindication to the immunization of healthy children scheduled for elective surgery. However, respecting a minimal delay of 2 days (inactivated vaccines) or 14-21 days (live attenuated viral vaccines) between immunization and anesthesia may be useful to avoid the risk of misinterpretation of vaccine-driven adverse events as postoperative complications.

Keywords
  • Adult
  • Anesthesia, General/adverse effects
  • Anesthetics/adverse effects
  • Causality
  • Child
  • Child, Preschool
  • Humans
  • Immunity/drug effects/immunology
  • Infant
  • Infant, Newborn
  • Lymphocytes/drug effects/immunology
  • Postoperative Complications/etiology
  • Vaccination/adverse effects
Citation (ISO format)
SIEBERT, Johan et al. Influence of anesthesia on immune responses and its effect on vaccination in children: review of evidence. In: Paediatric anaesthesia, 2007, vol. 17, n° 5, p. 410–420. doi: 10.1111/j.1460-9592.2006.02120.x
Main files (1)
Article (Published version)
accessLevelRestricted
Identifiers
ISSN of the journal1155-5645
547views
2downloads

Technical informations

Creation12/22/2014 2:28:00 PM
First validation12/22/2014 2:28:00 PM
Update time03/14/2023 10:34:49 PM
Status update03/14/2023 10:34:48 PM
Last indexation05/02/2024 3:54:03 PM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack