The Effect of Anaesthetic Agents on Platelet Function

Abstract

This paper reviews studies which have investigated the effect of anaesthetic agents on platelet function. The results of these studies suggest that halothane is the only agent in current use which inhibits platelet function in concentrations used clinically. Nitrous oxide appears to cause only a modest inhibition, while enflurane and isoflurane appear to have minimal or negligible effects. There is no current evidence that intravenous induction agents, opiates, or muscle relaxants affect platelet function. Reports indicate that local anaesthetic agents inhibit platelet aggregation, but only at concentrations far greater than peak plasma concentrations found during clinical use. Epidural anaesthesia may be associated with a reduction in platelet aggregation through a mechanism unrelated to direct local anaesthetic inhibition. The clinical significance of the effect of halothane on platelet function is not known. However, it is possible that halothane may affect bleeding or thrombotic complications in a similar manner to other 'anti-platelet' drugs.

Volatile anaesthetics reduce adhesion of blood platelets under low‐flow conditions in the coronary system of isolated guinea pig hearts

“…Anaesthetic agents possessing "anti-platelet" effects may protect against thrombus formation during or immediately after surgery. Some studies have demonstrated an effect of volatile anaesthetics on platelet aggregation (10). In vitm, halothane inhibited ADP-induced platelet aggregation in a dose-related and reversible manner.…”

Does point of care prothrombin time measurement reduce the transfusion of fresh frozen plasma in patients undergoing major surgery? The POC-OP randomized-controlled trial

“…Anesthetic management (general-, regional or a combined anesthesia) is defined by the attending anesthesiologist. Prothrombin time is not influenced by anesthetic gases, propofol, opiates, muscle relaxants and local anesthetics [33,34]. Propofol, desflurane, sevoflurane or isoflurane are used for general anesthesia in our Department.…”

Critically Ill Cancer Patients are not Consistently Hypercoagulable after Craniotomy

“…R indicates the time from the moment the sample starts to be tested until the beginning of fibrin formation (K) and the status of the clotting factors involved in the initial phases of coagulation [15,16]. K is an index of clot kinetics and firmness, whereas a is a measure of the speed at which the clot forms, and the maximum amplitude (MA) reflects the maximum strength of the clot and is a direct function of the dynamic properties of fibrin, fibrinogen level, and platelet function [15][16][17][18][19]. TMA is the Time to Maximum Amplitude or time to maximum strength.…”