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Jörn Heine, Dirk Scheinichen, Karsten Jaeger, Andreas Emmendoerffer, and Martin Leuwer

Administration of high-dose barbiturates may be used as an appropriate adjunctive treatment for control of intracranial pressure. The thiobarbiturate, thiopentone, has been reported to increase the rate of nosocomial pulmonary infection. This may be a substance-related effect of thiobarbiturates and it may be clinically important in barbiturate-sedated patients with severe head injury. Thus, the effects of the dose-response relationship of two commonly used barbiturates (thiopentone and methohexitone) on two vital aspects of neutrophil function were tested. We studied the production of superoxide anion during the respiratory burst by means of a flow cytometric method, and we assessed N-formyl-methionyleucylphenylalanine-induced neutrophil chemotaxis using the results produced by specific migration. The concentrations of thiopentone and methohexitone tested in vitro were adjusted to conform to the plasma concentrations reported for anesthesia and also to 10-fold higher concentrations. Only thiopentone dose dependently decreased respiratory burst and N-formyl-methionyleucylphenylalanine-induced chemotaxis. Methohexitone produced minimal effects in both concentrations. It was demonstrated that thiopentone had a direct effect on the intracellular respiratory burst oxidase enzyme system. The postulated free radical scavenging capacity of thiopentone was ruled out.