Effect of Propofol Anesthesia on Blood Coagulation and Fibrinolysis: An Assessment Using Thromboelastograph at Clipping of Cerebral Aneurysms

Abstract

Background: Propofol may cause perioperative bleeding because it has an inhibitory effect on platelet aggregation and an accelerative effect on blood fibrinolysis in vitro. The aim of this study was to evaluate the perioperative effect of propofol anesthesia on blood coagulation and fibrinolysis with a thromboelastograph in patients undergoing clipping of cerebral aneurysms. Methods: Fifteen patients who had cerebral aneurysms and no history of coagulation disorders were studied. Anesthesia was induced with a target controlled infusion of propofol to reach a calculated target blood concentration of /ml, and in addition, fentanyl /kg, lidocaine 1 mg/kg, esmolol 0.3 mg/kg and vecuronium 0.1 mg/kg were given intravenously. Anesthesia was maintained by propofol at target concentrations of 3-/ml with nitrous oxide (67%) and oxygen (33%). The hemoglobin concentration, platelet count and a thromboelastogram were measured at before, during and after anesthesia. Results: There was no significant difference in the perioperative hemoglobin concentration and platelet count. In terms of the thromboelastogram, r time (reaction time for clot formation) and k time (clot formation time) during and after anesthesia were shorter than hose before anesthesia (P