ANAESTHESIA AFFECTS PLASMA CONCENTRATIONS OF VASOPRESSIN, VON WILLEBRAND FACTOR AND COAGULATION FACTOR VIII IN CARDIAC SURGICAL PATIENTS

Operative stress may affect haemostatic mechanisms through hormonal systems. As the endocrine stress response to surgery may be modulated by anaesthesia, we have altered stress hormone concentrations by using either opioid or inhalation based anaesthesia to study haemostatic mechanisms in cardiac su...

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Bibliographic Details
Published in:British journal of anaesthesia : BJA 1993-02, Vol.70 (2), p.173-180
Main Authors: KUITUNEN, A., HYNYNEN, M., SALMENPERÄ, M., RASI, V., JÄRVINEN, A., SCHEININ, M., NEUVONEN, P.J., FYHRQUIST, F.
Format: Article
Language:English
Subjects:
Adult
Aged
Anesthesia
Anesthesia depending on type of surgery
Anesthesia, Inhalation
Anesthesia, Intravenous
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Arginine Vasopressin - blood
Biological and medical sciences
Blood Loss, Surgical
Blood: coagulation
Cardiopulmonary Bypass
Coronary Artery Bypass
Enflurane - pharmacology
Epinephrine - blood
Factor VIII - analysis
Female
Fentanyl - pharmacology
Hormones: vasopressin
Humans
Male
Medical sciences
Middle Aged
Norepinephrine - blood
Stress, Physiological - blood
Surgery: cardiopulmonary bypass
Thoracic and cardiovascular surgery. Cardiopulmonary bypass
von Willebrand Factor - analysis
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Summary:Operative stress may affect haemostatic mechanisms through hormonal systems. As the endocrine stress response to surgery may be modulated by anaesthesia, we have altered stress hormone concentrations by using either opioid or inhalation based anaesthesia to study haemostatic mechanisms in cardiac surgical patients. Thirty patients undergoing coronary artery surgery were allocated randomly to receive fentanyl (non-stress group) or enflurane (stress group) as the main anaesthetic agent. After cardiopu/monary bypass (CPB), plasma arginine vasopressin (AVP) concentrations were significantly (P < 0.001) greater in the stress group (81.8 (46.9–142.9) pg mt1, mean with 95% confidence limits) than in the non-stress group (5.8 (3.3–10.2) pg ml-1). Plasma noradrenaline and adrenaline concentrations increased similarly in both groups after CPB. Plasma concentrations of both von Willebrand factor (stress: 1.56(1.33–1.79) iu ml-1; non-stress: 1.00 (0.76–1.25) iu ml-1) and coagulation factor VIII: C (stress 1.15 (0.87–1.44) iu ml-1; non-stress: 0.69 (0.55–0.80) iu ml-1) were significantly (P
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/70.2.173