• Y Goto, C O'Malley, N F Fanning, J Wang, H P Redmond, and G D Shorten.
• Intensive Care Unit, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
• Ir J Med Sci. 2003 Oct 1; 172 (4): 191194191-4.

BackgroundBenzodiazepines, which are commonly administered perioperatively, can depress immune function. Neutrophil apoptosis plays a central role in the regulation of inflammation. This is particularly important during and after surgery.AimTo examine the effects of benzodiazepines (midazolam and diazepam) on neutrophil apoptosis.MethodsVenous blood samples were withdrawn from patients scheduled to undergo elective surgery, (a) immediately prior to, and 10 minutes after administration of midazolam 0.2 mg/kg intravenously (n=11) and (b) immediately prior to, and 60 minutes after administration of diazepam 10 mg p.o. (n=10). Neutrophil apoptosis was measured by Annexin V-FITC after 1 and 12 hours in culture.ResultsThe percentage of apoptotic cells was significantly less after midazolam at 12% (11.9) hours in culture compared to pre-midazolam 29.7% (13.3) (p<0.05). After diazepam, the rates of neutrophil apoptosis were also significantly less after 12 hours in culture (p<0.05).ConclusionAdministration of benzodiazepines in clinically relevant doses inhibits neutrophil apoptosis. In the perioperative period, this may influence the inflammatory response to surgery.

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