title: Peri-operative decreased cAMP levels in long-term alcoholic patients.
abstract: 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.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany. helge.schoenfeld@charite.de
authors.forename: H
authors.initials: H
authors.lastname: Schoenfeld
authors.forename: R
authors.initials: R
authors.lastname: Franke
authors.forename: C
authors.initials: C
authors.lastname: Von Heymann
authors.forename: U R
authors.initials: UR
authors.lastname: Doepfmer
authors.forename: A M
authors.initials: AM
authors.lastname: Blaicher
authors.forename: S
authors.initials: S
authors.lastname: Ziemer
authors.forename: C
authors.initials: C
authors.lastname: Spies
mesh_terms: 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
chemical_list: D012701:Serotonin; D000242:Cyclic AMP; D006152:Cyclic GMP