Peri-operative decreased cAMP levels in long-term alcoholic patients.
Long-term alcoholic patients have a five-fold higher risk of post-operative bleeding complications compared with nonalcoholic individuals. Serotonin increases and cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) decrease platelet aggregation. We examined the platelet-rich plasma levels of these substances and agonist-induced platelet aggregation in long-term alcoholic patients before and after surgery. Thirty-three consecutive patients (13 long-term alcoholics and 20 non-alcoholics) scheduled for tumour resections of the upper digestive tract were included in the study. The levels of cAMP were significantly decreased before and after surgery in long-term alcoholic patients, but there were no significant differences in cGMP and serotonin levels in alcoholic compared with non-alcoholic patients. In contrast to previous studies, no significantly altered aggregation responses in long-term alcoholics were found. A possible explanation is decreased inhibition through diminished cAMP levels; cGMP and serotonin do not seem to influence peri-operative haemostasis.
Schoenfeld
H
H
Department of Anaesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany. helge.schoenfeld@charite.de
Franke
R
R
Von Heymann
C
C
Doepfmer
U R
UR
Blaicher
A M
AM
Ziemer
S
S
Spies
C
C
D000368:Aged; D000437:Alcoholism / Q000097:blood* / Q000150:complications*; D016022:Case-Control Studies; D000242:Cyclic AMP / Q000097:blood*; D006152:Cyclic GMP / Q000097:blood; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007414:Intestinal Neoplasms / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation; D011183:Postoperative Complications / Q000097:blood* / Q000209:etiology; D012701:Serotonin / Q000097:blood
D012701:Serotonin; D000242:Cyclic AMP; D006152:Cyclic GMP