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 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.


CONCLUSIONS
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.
Ozer
E
E
University of Hacettepe, School of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey. heozer@superonline.com
Celiker
V
V
Aypar
U
U
Başgül
E
E
D000328:Adult; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D001780:Blood Coagulation Tests; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005342:Fibrinolysis; D006487:Hemostasis; D006801:Humans; D008297:Male; D010979:Platelet Function Tests; D011446:Prospective Studies; D014433:Tympanoplasty
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D