The Effects of Sodium Nitroprusside on Platelet Aggregation Function during Intracranial Aneurysm Operation under Isoflurane Anesthesia. |
Wha Ja Kang, Chang Ho Son, Keon Sik Kim, Young Kyoo Choi, Kwang Il Shin, Hee Joo Lee |
1Department of Anesthesiology, College of Medicine, Kyung Hee University, Seoul, Korea. 2Department of Clinical Pathology, College of Medicine, Kyung Hee University, Seoul, Korea. |
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Abstract |
BACKGROUND The intravenous infusion of sodium nitroprusside is widely used as a means of producing deliberate hypotension in a variety of clinical situations. However, sodium nitroprusside reported to inhibit platelet aggregation. So we studied the effects of sodium nitroprusside on platelet function in patients undergoing intracranial aneurysm surgery with isoflurane anesthesia. METHODS Platelet rich plasma from the patients receiving sodium nitroprusside was studied for aggregation in response to adenosine diphosphate, epinephrine and collagen. Maximum aggregation rate and maximum aggregation time were evaluated from the samples collected at pre-sodium nitroprusside infusion, 30min and 90min after sodium nitroprusside infusion, respectively. At the same time, bleeding time was measured. RESULTS The mean maximum aggregation rate of adenosine diphosphate, epinephrine and collagen at pre-sodium nitroprusside infusion decreased significantly 30min and 90min after sodium nitroprusside infusion, respectively(P<0.05). But the maximum aggregation time showed no significant change. Prolongation of bleeding time was not observed after sodium nitroprusside infusion.
Correlation between the total sodium nitroprusside dose delivered and the maximum aggregation rate of adenosine diphosphate, epinephrine and collagen were significant (r=0.797(P<0.05), r=0.732 (P<0.05) and r=0.737(P<0.05)). CONCLUSIONS In situation where sodium nitroprusside is administered for deliberate hypotensive anesthesia during intracranial aneurysm operation, the platelet aggregation was inhibited by sodium nitroprusside. However, bleeding time was not prolonged. |
Key Words:
Anesthetics; volatile isoflurane; Blood pressure induced hypotension; sodium nitroprusside; Blood platelet |
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