Effects of isoflurane, sevoflurane, and desflurane on platelet function: A prospective, randomized, single-blind, in vivo study

Bozdogan, Nesrin; Madenoğlu, Halit; Doğru, Kudret; Yildiz, Karamehmet; Kotanoğlu, Mustafa; Çetın, Mustafa; Boyacı, Adem

doi:10.1016/j.curtheres.2005.08.010

Cited by 10 publications

(14 citation statements)

References 26 publications

(3 reference statements)

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“…Clinically relevant antithrombotic effects of 1 MAC isoflurane, sevoflurane and desflurane was observed 15 min after intubation, by using platelet function analyzer (PFA-100) during minor surgery. Also, no significant difference was reported in INR, PT, aPTT as well as Hct, Hb and platelet count, at various timings [7].…”

Section: Discussionmentioning

confidence: 77%

“…Isoflurane, sevoflurane and desflurane anesthesia were reported to have relative clinical anticoagulant properties during minor surgical procedures [7]. Desflurane showed better postoperative hepatic function tests and INR results when compared with both isoflurane at equivalent doses [8] and total intravenous anesthesia (TIVA) with propofol-remifentanil [9].…”

Section: Introductionmentioning

confidence: 99%

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Perioperative effects of desflurane versus propofol on hemostasis guided by thromboelastometry in splenectomy with liver cirrhosis

Khafagy

Samhan

Ebied

et al. 2019

Egyptian Journal of Anaesthesia

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Background: Cirrhotic patients have impaired hemostasis with variable incidence of hypersplenism necessitating splenectomy. Rotation thromboelastometery (ROTEM) facilitates diagnosis and guides management. This study evaluates perioperative effects of desflurane versus propofol on hemostasis in cirrhotic patients undergoing splenectomy guided by ROTEM and laboratory hemostatic tests. Methods: Thirty hepatic Child A patients, ASA II-III, of either sex, aged 25-55 years, undergoing splenectomy were randomly allocated into two equal groups: Group D; anesthetized with desflurane 1 MAC (6%) and Group P; with propofol Target Controlled Infusion 2-5 µg/ml. Six blood samples were collected; preoperatively, after splenic artery ligation, immediately, first, third postoperative day then one month later. The samples were handled to measure complete blood picture, liver and kidney functions, screening coagulation tests (INR, PT and PTT), specific hemostatic factors (P-Selectin/CD62P, fibrinogen and D-dimer) as well as ROTEM criteria; clotting time (CT), clot formation time (CFT) and maximum clot firmness (MCF) via EX-TEM, IN-TEM and FIB-TEM commercial kits. Results: This study displayed postoperative hemoglobin reduction; however, platelet and WBCs as well as CT, CFT and MCF increased versus baseline. Screening and specific hemostatic factors as all other changes were within reference range and comparable between both groups. Conclusions: The current study concluded comparable effects of desflurane and propofol anesthesia on coagulation parameters within acceptable range as monitored by ROTEM and laboratory coagulation tests in cirrhotic patients with hypersplenism. Thus both anesthetics are considered safe in such patients who have high incidence of coagulopathy.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Perioperative effects of desflurane versus propofol on hemostasis guided by thromboelastometry in splenectomy with liver cirrhosis

Khafagy

Samhan

Ebied

et al. 2019

Egyptian Journal of Anaesthesia

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“…However, blood was collected for analysis of platelet function before administration of any anesthetic medication and performance of endoscopy, and there was at least a 14‐day recovery period before collection of the next blood sample. Additionally, the anesthetic protocol used in the related study (acepromazine, butorphanol, and isoflurane) has been shown to have no significant sustained effect on platelet function 36‐39 . However, the instruments used to assess platelet function in these studies were different than the instruments used in our study 36‐39 .…”

Section: Discussionmentioning

confidence: 76%

“…Additionally, the anesthetic protocol used in the related study (acepromazine, butorphanol, and isoflurane) has been shown to have no significant sustained effect on platelet function 36‐39 . However, the instruments used to assess platelet function in these studies were different than the instruments used in our study 36‐39 . Finally, our study only used 1 thromboprophylactic agent.…”

Section: Discussionmentioning

confidence: 82%

Effects of clopidogrel and prednisone on platelet function in healthy dogs

Thomason

Mooney

Price

et al. 2020

Veterinary Internal Medicne

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Background: Glucocorticoids cause hypercoagulability, but it is unknown if they counteract clopidogrel's antiplatelet effects.Hypothesis/Objectives: Determine the effects of clopidogrel and prednisone on platelet function.Animals: Twenty-four healthy dogs.Methods: Double-blinded, placebo-controlled randomized trial. Platelet function was evaluated using a platelet function analyzer and impedance aggregometry (days 0, 14, and 28) for dogs treated with placebo, clopidogrel (2-3 mg/kg/d), prednisone (2 mg/kg/d), or prednisone with clopidogrel PO for 28 days. Results were categorized as nonresponder versus responder (platelet function analyzer), and inadequate, ideal, or excessive response (aggregometry). Results were compared using mixed model, split-plot repeated measures analysis of variance and generalized estimating equation proportional odds models. P < .05 was considered significant. Results: Closure times differed by treatment (F [3, 20] = 10.5; P < .001), time (F [2, 40] = 14.3; P < .001), and treatment-by-time (F [6, 40] = 3.4; P = .01). Area under the curve (AUC) differed by treatment (F [3, 20] = 19.6; P < .001), time (F [2, 40] = 35.4; P < .001), and treatment-by-time (F [6, 40] = 13.5; P < .001).Based on closure times, 5/6 dogs each in the clopidogrel and prednisone/clopidogrel groups were responders. All dogs in the prednisone/clopidogrel group were overcontrolled based on AUC (days 14 and 28), whereas 5/6 (day 14) and 2/6 (day 28) dogs treated with clopidogrel were overcontrolled. Compared to clopidogrel, dogs receiving prednisone/clopidogrel were 11 times (P = .03) more likely to have an excessive response.Conclusions and Clinical Importance: Administration of clopidogrel/prednisone increases platelet dysfunction in healthy dogs. K E Y W O R D S antiplatelet, corticosteroid, glucocorticoid, immune-mediated hemolytic anemia, thromboprophylaxis Abbreviations: AUC, area under the curve; IMHA, immune-mediated hemolytic anemia; RI, reference intervals.

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“…The underlying mechanisms is thought to be through immediate inhibition of granulocyte-platelet aggregation by suppression of thromboxane A2 formation, inhibition of calcium mobilization in platelets and inhibition of platelet aggregation. [37,38,39] Significantly reduced platelet count detected in our study predominantly in CHC groups. Concurring with other studies which reported reduced platelet counts, due to platelet accumulation in liver during I/R.…”

Section: Discussionmentioning

confidence: 78%

MicroRNAs versus traditional biomarkers in predicting reperfusion injury in Hepatitis C Patients after major surgery

Demerdash

Arida

Zanaty

et al. 2018

APALM

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Background: Exposure to anesthesia in patients with chronic hepatitis C (CHC) may induce hepatic ischemia / reperfusion (I/R) with subsequent biochemical changes, provoked by alteration in molecular processes. This study explored miR-122 and miR-223 expression changes induced by anesthesia in CHC patients and their role in predicting hepatic I/R injury. Methods:This study included two hundered ASA II -III adult patients, scheduled for major surgery under general anesthesia. Patients were divided into 2 main groups; CHC patients group and non-hepatitis patients group. Each group was further divided into 2 equal subgroups (50 patients each) according to type of anesthesia received either Sevoflurane SC /S or Propofol PC/P ). Blood samples were analyzed for liver enzymes, prothrombin time, and serum lactate at several intervals; preoperative, 12 and 48 hours postoperative. Also, plasma miR-122 and miR-223 were estimated by Reverse Transcription PCR preoperative and 12 hours postoperative.Results: CHC groups showed significantly increased preoperative expression of both miR-122 and miR-223 compared to non-hepatitis groups (P<0.05). Moreover, postoperative samples revealed more exaggerated expression miR-122 and miR-223. Receiver operating characteristic curve (ROC) results revealed;values for area under the ROC for miR-122, miR-223, ALT and serum Lactate were 0.991, 0.965, 0.746 and 0.732 respectively. Based on the ROC finding, for prediction IR in CHC patients receiving anesthesia miR-122 had best Accuracy, sensitivity, and specificity. Conclusion:Our results suggested that both miR-122 and miR-223 could be regarded as more sensitive and specific biomarkers for predicting hepatic I/R injury than traditional biomarkers particularly in CHC patients undergoing major surgery.

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Effects of isoflurane, sevoflurane, and desflurane on platelet function: A prospective, randomized, single-blind, in vivo study

Cited by 10 publications

References 26 publications

Perioperative effects of desflurane versus propofol on hemostasis guided by thromboelastometry in splenectomy with liver cirrhosis

Perioperative effects of desflurane versus propofol on hemostasis guided by thromboelastometry in splenectomy with liver cirrhosis

Effects of clopidogrel and prednisone on platelet function in healthy dogs

MicroRNAs versus traditional biomarkers in predicting reperfusion injury in Hepatitis C Patients after major surgery

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