Mechanisms of anesthetic-induced immune dysregulation

Anesthesia is essential in modern surgical practice, ensuring patient comfort, immobility, and amnesia. However, its impact on the immune system has become a growing area of research, as anesthetic agents can modulate immune function in complex ways. Emerging evidence suggests that anesthetics may induce immune dysregulation, affecting both innate and adaptive immunity, with potential consequences for patient outcomes, particularly in the context of infection, inflammation and cancer. This review provides a comprehensive understanding of the immunological effects of anesthesia, exploring the molecular and cellular pathways involved. It examines how anesthetics can either suppress or modulate immune responses, depending on factors including drug type, dose and patient-specific characteristics. We discuss their influence on innate immunity, including the activity of natural killer cells, macrophages and neutrophils, as well as their impact on adaptive immunity, particularly T-cell activation, cytokine production and antigen presentation. In addition, we highlight the immunological consequences of commonly used anesthetic agents in clinical practice.