INFLUENCE OF SPINAL AND GENERAL ANAESTHESIA ON HAEMOSTASIS DURING TOTAL HIP ARTHROPLASTY

One hundred and one patients with osteoarthritis were randomly allocated to undergo total hip arthroplasty under either spinal (subarachnoid) or general anaesthesia. Venous blood was sampled before, during and after surgery and on the 5th day after operation to study the haemostatic mechanism. There...

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Bibliographic Details
Published in:British journal of anaesthesia : BJA 1987-05, Vol.59 (5), p.561-571
Main Authors: DAVIS, F.M., McDERMOTT, E., HICKTON, C., WELLS, E., HEATON, D.C., LAURENSON, V.G., GILLESPIE, W.J., FOATE, J.
Format: Article
Language:English
Subjects:
Aged
Anesthesia
Anesthesia depending on type of surgery
Anesthesia, General
Anesthesia, Spinal
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Antigens - analysis
Biological and medical sciences
Factor VIII - analysis
Factor VIII - immunology
Female
Fibrinolysis
Hemostasis
Hip Prosthesis
Humans
Male
Medical sciences
Orthopedic surgery. Maxillofacial surgery. Otorhinolaryngologic surgery. Stomatology. Ophtalmology. Investigation and treatment technics
Osteoarthritis - blood
Platelet Count
Thrombin - metabolism
Time Factors
von Willebrand Factor
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Summary:One hundred and one patients with osteoarthritis were randomly allocated to undergo total hip arthroplasty under either spinal (subarachnoid) or general anaesthesia. Venous blood was sampled before, during and after surgery and on the 5th day after operation to study the haemostatic mechanism. There were no preoper-ative differences between the two anaesthetic groups. Although there was pronounced individual variability, similar patterns of change in coagulation, platelets and fibrinolysis were seen in both groups. However, there were significant differences between the two groups in platelet count, thrombin production, and Factor VIIIRAg in the intra– and immediate postoperative periods. Also, compared with general anaesthesia, there was less intraoperative activation of fibrinolysis, as measured by the euglobulin clot lysis time, with spinal anaesthesia. These differences suggest slight modification of the haemostatic response to surgery with spinal anaesthesia, which could be consistent with a neuroendocrine mechanism. By the 5th day both groups exhibited a very similar “hypercoagulable” postoperative state.
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/59.5.561