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[Effect of controlled hypotension using sodium nitroprusside on platelet aggregation]. 1995

M Heesen, and G V Dietrich, and R Wirth, and M Ballesteros, and I Welters, and G Hempelmann
Departamento de Anestesiología y Cuidados Intensivos, Universidad Justus-Liebig, Giessen, Alemania.

OBJECTIVE To determine the influence of sodium nitroprusside (SNP) on platelet aggregation when this agent is used to induce hypotension during surgery. METHODS Spontaneous platelet aggregation (SPA) determined by impedance measurement and induced platelet aggregation (IPA) determined by turbidimetry were studied in 30 subjects scheduled for elective ear, nose or throat surgery. Fifteen patients in the SNP group (SNPG) received SNP in doses adjusted to maintain a mean arterial pressure of 50 mmHg. Another 15 patients who did not receive SNP served as controls. RESULTS SPA increased progressively in both groups. The greatest increase occurred after anesthetic induction (control group +172%, SNPG +48%); the highest level recorded was reached on the morning of the first day after surgery (control group +215%, SNPG +46%). IPA decreased after anesthetic induction (control group -21%, SNPG -40%) and stayed down throughout surgery. IPA was higher on the first morning after surgery than before the operation (control group +35%, SNPG +2%). SPA was significantly higher 60 minutes after start of surgery than before surgery in the control group; IPA and SPA were likewise higher in these patients the morning after surgery. CONCLUSIONS Platelet aggregation increases during surgery and in the immediate postoperative period. This increase is attenuated when SPA is given to induce hypotension. SPA should be determined by measurement of impedance in whole blood when the nature of platelet aggregation during surgery is being studied, given that early increases in IPA can be masked as a result of the low sensitivity of turbidimetry.

UI MeSH Term Description Entries
D007023 Hypotension, Controlled Procedure in which arterial blood pressure is intentionally reduced in order to control blood loss during surgery. This procedure is performed either pharmacologically or by pre-surgical removal of blood. Controlled Hypotension,Hypotension, Induced,Induced Hypotension
D007430 Intraoperative Care Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests. Care, Intraoperative
D007432 Intraoperative Period The period during a surgical operation. Intraoperative Periods,Period, Intraoperative,Periods, Intraoperative
D009300 Nasal Septum The partition separating the two NASAL CAVITIES in the midplane. It is formed by the SEPTAL NASAL CARTILAGE, parts of skull bones (ETHMOID BONE; VOMER), and membranous parts. Nasal Septums,Septum, Nasal,Septums, Nasal
D009391 Nephelometry and Turbidimetry Chemical analysis based on the phenomenon whereby light, passing through a medium with dispersed particles of a different refractive index from that of the medium, is attenuated in intensity by scattering. In turbidimetry, the intensity of light transmitted through the medium, the unscattered light, is measured. In nephelometry, the intensity of the scattered light is measured, usually, but not necessarily, at right angles to the incident light beam. Turbidimetry,Nephelometry,Turbidimetry and Nephelometry
D009599 Nitroprusside A powerful vasodilator used in emergencies to lower blood pressure or to improve cardiac function. It is also an indicator for free sulfhydryl groups in proteins. Nitroferricyanide,Sodium Nitroprusside,Cyanonitrosylferrate,Ketostix,Naniprus,Nipride,Nipruton,Nitriate,Nitropress,Nitroprussiat Fides,Nitroprusside, Disodium Salt,Nitroprusside, Disodium Salt, Dihydrate,Disodium Salt Nitroprusside,Nitroprusside, Sodium
D010974 Platelet Aggregation The attachment of PLATELETS to one another. This clumping together can be induced by a number of agents (e.g., THROMBIN; COLLAGEN) and is part of the mechanism leading to the formation of a THROMBUS. Aggregation, Platelet
D010975 Platelet Aggregation Inhibitors Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system. Antiaggregants, Platelet,Antiplatelet Agent,Antiplatelet Agents,Antiplatelet Drug,Blood Platelet Aggregation Inhibitor,Blood Platelet Antagonist,Blood Platelet Antiaggregant,PAR-1 Antagonists,Platelet Aggregation Inhibitor,Platelet Antagonist,Platelet Antagonists,Platelet Antiaggregant,Platelet Antiaggregants,Platelet Inhibitor,Protease-Activated Receptor-1 Antagonists,Antiplatelet Drugs,Blood Platelet Aggregation Inhibitors,Blood Platelet Antagonists,Blood Platelet Antiaggregants,Platelet Inhibitors,Agent, Antiplatelet,Aggregation Inhibitor, Platelet,Antagonist, Blood Platelet,Antagonist, Platelet,Antiaggregant, Blood Platelet,Antiaggregant, Platelet,Drug, Antiplatelet,Inhibitor, Platelet,Inhibitor, Platelet Aggregation,PAR 1 Antagonists,Platelet Antagonist, Blood,Platelet Antiaggregant, Blood,Protease Activated Receptor 1 Antagonists
D010979 Platelet Function Tests Laboratory examination used to monitor and evaluate platelet function in a patient's blood. Function Test, Platelet,Function Tests, Platelet,Platelet Function Test,Test, Platelet Function,Tests, Platelet Function
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods

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