Anesthesia with sevoflurane, but not isoflurane, prolongs bleeding time in humans

Yokubol, Bencharatana; Hirakata, Hideo; Nakamura, Kumi; Sai, Satoko; Okuda, Hiroto; Hatano, Yoshio; Urabe, Nobukata; Mori, Kenjiro

doi:10.1007/s005400050056

Cited by 11 publications

(7 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This contrasts with previous studies of noncardiac surgery suggesting that sevoflurane increases risk of postoperative bleeding. 19,25 This discrepancy may reflect the different types of surgery involved, as well as the small samples in those previous studies. The proportion of patients needing PRBC transfusion in our sevoflurane group was as low as 30.3%, suggesting that low-dose sevoflurane reduces the requirements for PRBC transfusion to a similar extent as aprotinin and tranexamic acid.…”

Section: Discussionmentioning

confidence: 79%

Low-Dose Sevoflurane May Reduce Blood Loss and Need for Blood Products After Cardiac Surgery

et al. 2016

View full text Add to dashboard Cite

Patients undergoing cardiac surgery often experience abnormal bleeding, due primarily to cardiopulmonary bypass (CPB)-induced activation of platelets. Sevoflurane may inhibit platelet activation, raising the possibility that administering it during CPB may reduce blood loss.Patients between 18 and 65 years old who were scheduled for cardiac surgery under CPB at our hospital were prospectively enrolled and randomized to receive intravenous anesthetics alone (control group, n = 77) or together with sevoflurane (0.5–1.0 vol/%) from an oxygenator (sevoflurane group, n = 76). The primary outcome was postoperative blood loss, the secondary outcome was postoperative need for blood products.Volume of blood loss was 48% lower in the sevoflurane group than the control group at 4 hours after surgery, and 33% lower at 12 hours after surgery. Significantly fewer patients in the sevoflurane group lost >700 mL blood within 24 hours (9 of 76 vs 28 of 77, P < 0.001). As a result, the sevoflurane group received significantly smaller volumes of packed red blood cells (1.25 ± 2.36 vs 2.23 ± 3.75 units, P = 0.011) and fresh frozen plasma (97 ± 237 vs 236 ± 344 mL, P = 0.004). Thus the sevoflurane group was at significantly lower risk of requiring complex blood products after surgery (adjusted odds ratio [OR] 0.34, 95% confidence interval [CI] 0.17–0.68, P = 0.002).Sevoflurane inhalation from an oxygenator during CPB may reduce blood loss and need for blood products after cardiac surgery.

show abstract

Section: Discussionmentioning

confidence: 79%

Low-Dose Sevoflurane May Reduce Blood Loss and Need for Blood Products After Cardiac Surgery

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The underlying mechanisms is thought to be through immediate inhibition of granulocyte-platelet aggregation by suppression of thromboxane A2 formation, inhibition of calcium mobilization in platelets and inhibition of platelet aggregation. [37,38,39] Significantly reduced platelet count detected in our study predominantly in CHC groups. Concurring with other studies which reported reduced platelet counts, due to platelet accumulation in liver during I/R.…”

Section: Discussionmentioning

confidence: 83%

“…Concurring with other studies which reported reduced platelet counts, due to platelet accumulation in liver during I/R. [39,40,41] Kurokawa et al stated that platelets adhered to Kupffer cells at the early period of I/R and that those platelets were involved in apoptosis of hepatocytes and subsequently stimulated platelet migration from sinusoidal space into the space of Disse. [42] Significant reduction in MAP was observed in Sevoflurane anesthesia groups (S and SC) intra-operative and at the end of surgery may be the result of impaired auto-regulation.…”

Section: Discussionmentioning

confidence: 94%

MicroRNAs versus traditional biomarkers in predicting reperfusion injury in Hepatitis C Patients after major surgery

Demerdash

Arida

Zanaty

et al. 2018

APALM

View full text Add to dashboard Cite

Background: Exposure to anesthesia in patients with chronic hepatitis C (CHC) may induce hepatic ischemia / reperfusion (I/R) with subsequent biochemical changes, provoked by alteration in molecular processes. This study explored miR-122 and miR-223 expression changes induced by anesthesia in CHC patients and their role in predicting hepatic I/R injury. Methods:This study included two hundered ASA II -III adult patients, scheduled for major surgery under general anesthesia. Patients were divided into 2 main groups; CHC patients group and non-hepatitis patients group. Each group was further divided into 2 equal subgroups (50 patients each) according to type of anesthesia received either Sevoflurane SC /S or Propofol PC/P ). Blood samples were analyzed for liver enzymes, prothrombin time, and serum lactate at several intervals; preoperative, 12 and 48 hours postoperative. Also, plasma miR-122 and miR-223 were estimated by Reverse Transcription PCR preoperative and 12 hours postoperative.Results: CHC groups showed significantly increased preoperative expression of both miR-122 and miR-223 compared to non-hepatitis groups (P<0.05). Moreover, postoperative samples revealed more exaggerated expression miR-122 and miR-223. Receiver operating characteristic curve (ROC) results revealed;values for area under the ROC for miR-122, miR-223, ALT and serum Lactate were 0.991, 0.965, 0.746 and 0.732 respectively. Based on the ROC finding, for prediction IR in CHC patients receiving anesthesia miR-122 had best Accuracy, sensitivity, and specificity. Conclusion:Our results suggested that both miR-122 and miR-223 could be regarded as more sensitive and specific biomarkers for predicting hepatic I/R injury than traditional biomarkers particularly in CHC patients undergoing major surgery.

show abstract

“…8 This may impair platelet aggregation and prolong bleeding by 40%. 9 The antiplatelet effect of sevoflurane exceeds that of isoflurane. 10 The antiplatelet actions do not necessarily lead to clinically significant bleeding complications, as shown by the example of aspirin.…”

Section: Discussionmentioning

confidence: 99%

Possible Interaction Between Sevoflurane and Aloe vera

et al. 2004

View full text Add to dashboard Cite

show abstract

Anesthesia with sevoflurane, but not isoflurane, prolongs bleeding time in humans

Abstract: Sevoflurane alters bleeding time in the clinical situation.

Cited by 11 publications

References 15 publications

Low-Dose Sevoflurane May Reduce Blood Loss and Need for Blood Products After Cardiac Surgery

Low-Dose Sevoflurane May Reduce Blood Loss and Need for Blood Products After Cardiac Surgery

MicroRNAs versus traditional biomarkers in predicting reperfusion injury in Hepatitis C Patients after major surgery

Possible Interaction Between Sevoflurane and Aloe vera

Contact Info

Product

Resources

About