The influence of propofol and sevoflurane on hemostasis: a rotational thromboelastographic study

Koo, Bon Wook; Na, Hyo Seok; Jeon, Young Tae; Hwang, Jung Won; Do, Sang Hwan

Clinical Research

General Article

Anesthesia and Pain Medicine 2014;9(4):292-297.
Published online October 31, 2014.

The influence of propofol and sevoflurane on hemostasis: a rotational thromboelastographic study

Bon Wook Koo, Hyo Seok Na, Young Tae Jeon, Jung Won Hwang, Sang Hwan Do

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. hsknana@gmail.com

Received: 4 July 2014 • Revised: 3 September 2014 • Accepted: 11 September 2014

Abstract

BACKGROUND
Using rotational thromboelastometry (ROTEM) analysis, we investigated the difference in blood hemostasis, based on the primary anesthetic agents used during general anesthesia.
METHODS
Sixty-six adult patients scheduled for elective ophthalmic surgery under general anesthesia were evaluated with regard to changes in each parameter in INTEM, EXTEM, and FIBTEM analyses. The patients received intravenous anesthesia with propofol and remifentanil (TIVA group) or inhalation anesthesia with sevoflurane (SEVO group). The ROTEM tests were performed 10 min before starting anesthesia and 1 h after finishing anesthesia. The INTEM and EXTEM analyses included the clotting time (CT), clot firmness time (CFT), alpha angle (alpha), and maximum clot firmness (MCF). The FIBTEM analyzed only MCF. Maximum clot elasticity (MCE) was calculated by (MCF x 100) / (100 - MCF). The platelet component of clot strength was calculated as follows: MCE(platelet) = MCE(EXTEM) - MCE(FIBTEM).
RESULTS
The preoperative and postoperative parameters (CT, CFT, alpha, and MCF) in the INTEM, EXTEM, and FIBTEM analyses were not significantly different between the two groups. The MCE(platelet) also did not show a significant difference.
CONCLUSIONS
Presuming that the ophthalmic surgery had a minimal traumatic effect, we conclude that both anesthetic agents cause negligible changes in ROTEM analyses postoperatively.

Key Words: Hemostasis, Propofol, Rotational thromboelastometry, Sevoflurane