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ANESTHETIC PHARMACOLOGY

Intravenous Fentanyl Increases Natural Killer Cell Cytotoxicity and Circulating CD16⁺ Lymphocytes in Humans

Mark P. Yeager, MD^*, Marcia A. Procopio, MD^*, Joyce A. DeLeo, PhD^*, Janice L. Arruda, BA^*, Laurie Hildebrandt, BAMT^*, and Alexandra L. Howell, PhD

Departments of *Anesthesiology, Medicine, Pharmacology, and Microbiology, Dartmouth Medical School, Hanover, New Hampshire; The Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; and The Veterans Administration Medical Center, White River Junction, Vermont

Address correspondence to Mark P. Yeager, MD, Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH 03756. Address e-mail to mark.p.yeager{at}hitchcock.org No reprints will be available.

Opioids, including fentanyl, are often administered to patients who may be at risk for the consequences of impaired immune function. We performed a clinical study to test the effects of the synthetic opioid fentanyl on human immune function. Participants received an IV fentanyl initial dose of 3 µg/kg followed by a 2-h IV infusion of 1.2 µg · kg^-1 · h^-1. Peripheral blood was drawn before and after fentanyl administration to test for neutrophil phagocytic function, neutrophil antibody-dependent cell cytotoxicity, natural killer cell cytotoxicity, percentage of lymphocyte populations, T-lymphocyte proliferative response, and in vivo antibody response to a pneumococcal vaccine inoculation given at the end of the fentanyl infusion. Fentanyl exposure under the conditions of this study caused a rapid and significant increase in natural killer cell cytotoxicity, which was coincident with an increase in the percentage of CD16⁺ and CD8⁺ cells in peripheral blood. Fentanyl did not significantly affect any of the other immune measurements.

IMPLICATIONS: Many previous studies have suggested that opioid drugs can impair immune resistance in patients who may be at risk for infection. This study suggests that the opioid fentanyl, when given to healthy humans without coexisting diseases, does not suppress immune resistance. On the basis of these results, the use of fentanyl should not be restricted because of concerns that it may suppress immune function.

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