Effect of preoperative aprotinin on blood coagulation in patients undergoing meningioma resection / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the effects of different low doses of aprotinin given before operation on blood coagulation in patients undergoing meningioma resection. Methods Sixty ASA Ⅰ or Ⅱ patients aged 18-60 yrs were randomized to receive intravenous aprotinin 0.5 or 1.0 or 2.0?106 KIU (group Apro 1, 2, 3) or normal saline (control group) before operation. 6% hydroxyethyl starch (HES) 1 000 ml was infused at 25 ml?min-1 after induction of general anesthesia. Venous blood samples were taken before aprotinin was given ( T1 , baseline), before operation after aprotinin was given (T2), while the tumor was being resected (T3), at the end of surgery (T4) and 24h after operation (T5) for routine blood and coagulation tests including Hb, Hct, RBC, WBC and PLT counts, activated partial thromboplastin time (APTT), prothrombin time (PT) fibrinogen concentration (FIB) and thrombin time (TT) and tests using Sonoclot coagulation and platelet function analyzer including Sonoclot activated clotting time (Son ACT), rate of clot formation (CR) and platelet function (PF). Results The 4 groups were comparable with respect to demographic data, duration of operation, uine output, amount of fluid infused and blood loss during operation and volume of the tumor. RBC count, Hb, Hct and PLT count were significantly decreased during and after operation (T2-5) while WBC counts were significantly increased at T5 as compared with the baseline values at T1 in the 4 groups. PT was significantly prolonged and FIB and CR significantly decreased in the 4 groups; APTT was significantly prolonged in group Apro 2 and 3; PF was significantly increased in group Apro 3 during operation at T2-4 as compared to the baseline values at T1 but all returned to normal level after operation at T5 .Conclusions Preoperative aprotinin 1.0 and 2.0?106 KIU can prolong APTT. Aprotinin 2.0?106 KIU provides effective protection of platelet function.