Influence of total intravenous and inhalational anaesthesia on haemostasis during tympanoplasty

Background:  Surgical trauma leads to systemic changes in haemostasis. Haematological changes activated by surgery may become so prominent that changes caused by anaesthesia might be hidden or underestimated. Therefore, we have undertaken a prospective study to compare the behaviour of selected fact...

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Veröffentlicht in:Acta anaesthesiologica Scandinavica 2003-11, Vol.47 (10), p.1242-1247
Hauptverfasser: Özer, E., Çeli̇ker, V., Aypar, Ü., Başgül, E.
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container_start_page 1242
container_title Acta anaesthesiologica Scandinavica
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creator Özer, E.
Çeli̇ker, V.
Aypar, Ü.
Başgül, E.
description Background:  Surgical trauma leads to systemic changes in haemostasis. Haematological changes activated by surgery may become so prominent that changes caused by anaesthesia might be hidden or underestimated. Therefore, we have undertaken a prospective study to compare the behaviour of selected factors involved in the coagulation and fibrinolytic systems. Methods:  Forty healthy adult patients scheduled for otological surgery were enrolled in the study. Upon receiving informed consent, they were randomly assigned to receive either inhalational (IA) or total intravenous anaesthesia (TIVA). Platelet function (PFA100TM), disseminated intravascular coagulopathy (DIC) panel, and generalized d‐dimer (GFC) were studied during certain periods of anaesthesia to identify the changes in haemostasis. Results:  Statistically, no significant change in DIC parameters were encountered between the two groups. No statistical difference was found between the two groups in the measured coagulation parameters, but statistically GFC showed slight activation in the 1st hour of surgical intervention. Conclusion:  Presuming a minimal traumatic effect of surgical procedure on the determined variables, we conclude that different anaesthetic techniques have a negligible effect on platelet activation and fibrinolysis. The clinical relevance of coagulation activation and fibrinolysis during different anaesthetic techniques remains to be investigated.
doi_str_mv 10.1046/j.1399-6576.2003.00234.x
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Haematological changes activated by surgery may become so prominent that changes caused by anaesthesia might be hidden or underestimated. Therefore, we have undertaken a prospective study to compare the behaviour of selected factors involved in the coagulation and fibrinolytic systems. Methods:  Forty healthy adult patients scheduled for otological surgery were enrolled in the study. Upon receiving informed consent, they were randomly assigned to receive either inhalational (IA) or total intravenous anaesthesia (TIVA). Platelet function (PFA100TM), disseminated intravascular coagulopathy (DIC) panel, and generalized d‐dimer (GFC) were studied during certain periods of anaesthesia to identify the changes in haemostasis. Results:  Statistically, no significant change in DIC parameters were encountered between the two groups. No statistical difference was found between the two groups in the measured coagulation parameters, but statistically GFC showed slight activation in the 1st hour of surgical intervention. Conclusion:  Presuming a minimal traumatic effect of surgical procedure on the determined variables, we conclude that different anaesthetic techniques have a negligible effect on platelet activation and fibrinolysis. The clinical relevance of coagulation activation and fibrinolysis during different anaesthetic techniques remains to be investigated.</description><identifier>ISSN: 0001-5172</identifier><identifier>EISSN: 1399-6576</identifier><identifier>DOI: 10.1046/j.1399-6576.2003.00234.x</identifier><identifier>PMID: 14616321</identifier><identifier>CODEN: AANEAB</identifier><language>eng</language><publisher>Oxford, UK: Munksgaard International Publishers</publisher><subject>Adult ; Anesthesia ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Anesthesia. Intensive care medicine. Transfusions. 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Haematological changes activated by surgery may become so prominent that changes caused by anaesthesia might be hidden or underestimated. Therefore, we have undertaken a prospective study to compare the behaviour of selected factors involved in the coagulation and fibrinolytic systems. Methods:  Forty healthy adult patients scheduled for otological surgery were enrolled in the study. Upon receiving informed consent, they were randomly assigned to receive either inhalational (IA) or total intravenous anaesthesia (TIVA). Platelet function (PFA100TM), disseminated intravascular coagulopathy (DIC) panel, and generalized d‐dimer (GFC) were studied during certain periods of anaesthesia to identify the changes in haemostasis. Results:  Statistically, no significant change in DIC parameters were encountered between the two groups. No statistical difference was found between the two groups in the measured coagulation parameters, but statistically GFC showed slight activation in the 1st hour of surgical intervention. Conclusion:  Presuming a minimal traumatic effect of surgical procedure on the determined variables, we conclude that different anaesthetic techniques have a negligible effect on platelet activation and fibrinolysis. The clinical relevance of coagulation activation and fibrinolysis during different anaesthetic techniques remains to be investigated.</description><subject>Adult</subject><subject>Anesthesia</subject><subject>Anesthesia, Inhalation</subject><subject>Anesthesia, Intravenous</subject><subject>Anesthesia. Intensive care medicine. Transfusions. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood Coagulation Tests</topic><topic>Coagulation</topic><topic>Female</topic><topic>Fibrin Fibrinogen Degradation Products - analysis</topic><topic>Fibrinolysis</topic><topic>General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. 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No statistical difference was found between the two groups in the measured coagulation parameters, but statistically GFC showed slight activation in the 1st hour of surgical intervention. Conclusion:  Presuming a minimal traumatic effect of surgical procedure on the determined variables, we conclude that different anaesthetic techniques have a negligible effect on platelet activation and fibrinolysis. The clinical relevance of coagulation activation and fibrinolysis during different anaesthetic techniques remains to be investigated.</abstract><cop>Oxford, UK</cop><pub>Munksgaard International Publishers</pub><pmid>14616321</pmid><doi>10.1046/j.1399-6576.2003.00234.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Wiley Online Library Journals Frontfile Complete
subjects Adult
Anesthesia
Anesthesia, Inhalation
Anesthesia, Intravenous
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Blood Coagulation Tests
Coagulation
Female
Fibrin Fibrinogen Degradation Products - analysis
Fibrinolysis
General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation
GFC
Hemostasis
Humans
inhalational anaesthesia
Male
Medical sciences
PFA 100TM
Platelet Function Tests
Prospective Studies
TIVA
Tympanoplasty
title Influence of total intravenous and inhalational anaesthesia on haemostasis during tympanoplasty
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