Effects of hydroxyethyl starch 130/0.4 on blood coagulation function and platelet function in the elderly

Abstract

Objective To assess the effects of hydroxyethyl starch (HES) 130/0.4 on blood coagulation function and platelet function in the elderly.Methods Thirty elderly patients undergoing gastric and intestinal tumor resection under general anesthesia were randomly assigned to one of 2 groups ( n = 15 each):HES group and normal saline group (group NS).The patients were premedicated with im phenobarbital 0.1 g and scopolamine 0.3 mg.Anesthesia was induced with midazolam 0.02-0.05 mg/kg,fentunyl 3-5 μg/kg,prepofol 1-2 mg/kg,vecuronium 2 mg and succinylcholine 1-1.5 mg/kg and maintained with isoflurune (end-tidal concentration 0.5 %-1.5% ) and intermittent iv boluses of fentanyl and vecurunium after tracheal intubation.HES or NS 25 ml/kg was infused after tracheal intubation at a rate of 10-15 ml·kg-1·h-1 through central venous line. Venous blood samples were taken before (T1,baseline) and at 30 min (T2) and 4 h (T3) after HES or NS infusion for determination of hemoglobin (Hb),platelet count (Plt),prothrombin time (PT),activated partial thromboplastin time (APTT) and fibrinogen level (FIB),plasma factor Ⅷ,yon Willebrand factor (vWF).Glass bead activated whole blood clotting time (gbACT),clot rate and platelet function were also measured at the 3 time points using Sonoclot analyzer.Results The 2 groups were comparable with respect to M/F sex ratio,age,body weight and duration of operation.Hb and Pit were significantly decreased at T2and T3 after HES or NS infusion as compared with the baseline values at T1 before infusion.There was no significant change in PT,APTT,FIB,Ⅷ ,vWF,gbACT,clot rate and PIT function after infusion in both groups.Conclusion Infusion of HES 130/0.4 25 ml/kg during operation does not have significant effects on blood coagulation function and platelet function in the elderly. Key words: Hetastarch; Aged; Blood coagulation tests; Platelet function tests