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Desflurane inhibits platelet function in vitro similar to halothane

Published online by Cambridge University Press:  11 July 2005

T. Berlet
Affiliation:
University Hospital, Department of Anaesthesiology, Cologne, Germany
A. Krah
Affiliation:
University Hospital, Department of Transfusion Medicine, Cologne, Germany
U. Börner
Affiliation:
University Hospital, Department of Anaesthesiology, Cologne, Germany
B. S. Gathof
Affiliation:
University Hospital, Department of Transfusion Medicine, Cologne, Germany
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Abstract

Summary

Background and objective: The effects of the volatile anaesthetic desflurane on platelet activation in vitro were studied and compared to those of halothane.

Methods: Platelet-rich plasma was exposed to 2 MAC of desflurane or halothane, or air only and stimulated by platelet agonists ADP (2.5, 5 and 10 μmol L−1) and collagen (10 μg mL−1). Platelet response was measured by Born aggregometry (maximum aggregation response, area under the curve) and flow cytometry (mean channel fluorescence, percentage of CD62P-positive cells, index of platelet activation for positive platelets).

Results: Aggregation response was significantly reduced in platelets exposed to desflurane or halothane; the inhibitory effect was more pronounced when the areas under the curve were analysed: values ranged from 37.5% to 73.3% of control samples for ADP stimulation and 77.1% to 79.8% for collagen stimulation. CD62P expression before and after stimulation with receptor agonists was not statistically different in platelets exposed to desflurane, halothane or air.

Conclusions: By impairing platelet aggregation while not affecting α-degranulation desflurane has a differential effect on various aspects of platelet activation similar to halothane. Our results are compatible with the hypothesis of an impairment of platelet thromboxane receptor signalling by halothane. We suggest a similar mechanism for desflurane.

Type
Original Article
Copyright
2003 European Society of Anaesthesiology

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References

Ueda I. The effects of volatile general anesthetics on adenosine diphosphate-induced platelet aggregation. Anesthesiology 1971; 34: 405408.Google Scholar
Dalsgaard-Nielsen J, Risbo A, Simmelkjaer P, Gormsen J. Impaired platelet aggregation and increased bleeding time during general anaesthesia with halothane. Br J Anaesth 1981; 53: 10391042.Google Scholar
Fyman PN, Triner L, Schranz H, et al. Effect of volatile anaesthetics and nitrous oxide-fentanyl anaesthesia on bleeding time. Br J Anaesth 1984; 56: 11971200.Google Scholar
De Rossi LW, Horn NA, Baumert JH, Gutensohn K, Hutschenreuter G, Rossaint R. Xenon does not affect human platelet function in vitro. Anesth Analg 2001; 93: 635640.Google Scholar
Cambria RP, Megerman J, L'Italien G, Warnock D, Strauss HW, Abbott WM. The effect of halothane anesthesia on platelet aggregation in vivo: decreased deposition on polytetrafluoroehtylene arterial grafts in dogs. Surgery 1983; 93: 752757.Google Scholar
Schlack W, Preckel B, Stunneck D, Thämer V. Effects of halothane, enflurane, isoflurane, sevoflurane and desflurane on myocardial reperfusion injury in the isolated rat heart. Br J Anaesth 1998; 81: 913919.Google Scholar
Longnecker DE, Miller FL. Pharmacology of inhalational anesthetics. In: Rogers MC, et al., eds. Principles and Practice of Anesthesiology.St. Louis, USA: Mosby, 1993: 10531086.
Baden JM, Rice SA. Metabolism and toxicity of inhaled anesthetics. In: Miller RD, ed. Anaesthesia, 5th edn. New York, USA: Churchill Livingstone, 2000: 156162.
Leytin V, Mody M, Semple JW, Garbey B, Freedman J. Flow cytometric parameters for characterizing platelet activation by measuring P-selectin (CD62) expression: theoretical consideration and evaluation in thrombin-treated platelet populations. Biochem Biophys Res Commun 2000; 269: 8590.Google Scholar
Snyder EL, Hezzey A, Katz AJ, Bock J. Occurrence of the release reaction during preparation and storage of platelet concentrates. Vox Sang 1981; 41: 172177.Google Scholar
Holmsen H. Platelet secretion and energy metabolism. In: Colman RW, Hirsch J, Marder VJ, Salzman EW, eds. Hemostasis and Thrombosis, 3rd edn. Philadelphia, USA: Lippincott, 1994: 524540.
Reuter HD. Basic Elements and Practice of Platelet Function Diagnostics, 2nd edn. Köln, Germany: Science Data Supply, 1999.
Colman RW, Cook JJ, Niewiarowski S. Mechanisms of platelet aggregation. In: Colman RW, Hirsch J, Marder VJ, Salzman EW, eds. Hemostasis and Thrombosis, 3rd edn. Philadelphia, USA: Lippincott, 1994: 508523.
Charo LF, Dieffer N, Phillips DR. Platelet membrane glycoproteins. In: Colman RW, Hirsch J, Marder VJ, Salzman EW, eds. Hemostasis and Thrombosis, 3rd edn. Philadelphia, USA: Lippincott, 1994: 489503.
Merten M, Thiagarajan P. P-selectin expression on platelets determines size and stability of platelet aggregates. Circulation 2000; 102: 19311936.Google Scholar
Matzdorff AC, Kemkes-Matthes B, Voss R, Pralle H. Comparison of β-thromboglobulin, flow cytometry, and platelet aggregometry to study platelet activation. Haemostasis 1996; 26: 98106.Google Scholar
Walter F, Vulliemoz Y, Verosky M, Triner L. Effects of halothane on the cyclic 3′,5′ adenosine monophosphate enzyme system in human platelets. Anesth Analg 1980; 59: 856861.Google Scholar
Dalsgaard-Nielsen J, Gormsen J. Effects of halothane on platelet function. Thromb Haemost 1980; 44: 143145.Google Scholar
Hirakata H, Ushikubi F, Narumiya S, Hatano Y, Nakamura K, Mori K. The effect of inhaled anesthetics on the platelet aggregation and the ligand-binding affinity of the platelet thromboxane A2-receptor. Anesth Analg 1995; 81: 114118.Google Scholar
Hirakata H, Ushikubi F, Toda H, et al. Sevoflurane inhibits human platelet aggregation and thromboxane A2 formation, possibly by suppression of cyclooxygenase activity. Anesthesiology 1996; 85: 14471453.Google Scholar
Hirakata H, Nakamura K, Sai S, et al. Platelet aggregation is impaired during anaesthesia with sevoflurane but not with isoflurane. Can J Anesth 1997; 44: 11571161.Google Scholar
Kohro S, Yamakage M. Direct inhibitory mechanisms of halothane on human platelet aggregation. Anesthesiology 1996; 85: 96106.Google Scholar
Corbin F, Blaise G, Sauvé R. Differential effect of halothane and forskolin on platelet cytosolic Ca2+ mobilization and aggregation. Anesthesiology 1998; 89: 401410.Google Scholar
Hönemann CW, Nietgen GW, Podranski T, Chan CK, Durieux ME. Influence of volatile anesthetics on thromboxane A2 signaling. Anesthesiology 1998; 88: 440451.Google Scholar
Nygård E, Naesh O, Hindberg I, Valentin N. Effect of nitrous oxide and volatile anaesthetics on platelet function in man. Acta Anaesthesiol Scand 1994; 38: 4042.Google Scholar
Fröhlich D, Rothe G, Schmitz G, Hansen E. Volatile anaesthetics induce changes in the expression of P-selectin and glycoprotein Ib on the surface of platelets in vitro. Eur J Anaesthesiol 1998; 15: 641648.Google Scholar
Eger EI. Uptake and distribution. In: Miller RD, ed. Anesthesia, 5th edn. New York, USA: Churchill Livingstone, 2000: 7494.