The Effects of Propofol-remifentanil Total Intravenous Anesthesia on Platelet Function / 대한마취과학회지

ABSTRACT

BACKGROUND: The majority of anesthetic agents, including inhalation anesthetics, inhibit platelet function, but the effect of propofol on platelets is controversial. This study was designed to compare the effects of propofol-remifentanil total intravenous anesthesia and sevoflurane inhalation anesthesia on platelet function. METHODS: Patients undergoing major hip surgery were divided into two groups inhalation anesthesia with sevoflurane or total intravenous anesthesia with propofol and remifentanil. Hemoglobin, hematocrit, platelet count, prothrombin time, activated partial thromboplastin time, and platelet aggregation were measured 5 minutes before induction, the first hour intra-operatively, and the first hour postoperatively. RESULTS: Total intravenous anesthesia with propofol and remifentanil significantly diminished collagen-induced platelet aggregation values intraoperatively compared with preoperative values. Also, intraoperative collagen- and adenosine diphosphate (ADP)-induced platelet aggregation was significantly lower in anesthesia with propofol and remifentanil compared with sevoflurane anesthesia.Sevoflurane did not induce significant changes in collagen- or ADP-induced platelet aggregation. CONCLUSIONS: Total intravenous anesthesia with propofol and remifentanil significantly reduced collagen-induced platelet aggregation intraoperatively, while inhalation anesthesia with sevoflurane did not reduce collagen-or ADP-induced platelet aggregation at all.