Platelet Function in Surgical Stress

Summary

Ten patients for elective cholecystectomy were studied pre-, per- and postoperatively. All had neurolept anesthesia. Plasma concentrations of β-TG, TXB₂ and 5-HT and intraplatelet 5-HT were measured. Aggregation to ADP was recorded.

Serum cortisol concentration was used as index of the stress response, showing peroperative increase and postoperative decrease. Closely related to this we observed a significant increase in P-β-TG and P-TXB₂ with postoperative normalization in 6 patients without complications. P-5-HT had a peak peropera-tively and remained elevated postoperatively. A negative correlation between P--5-HT and decreasing intraplatelet 5-HT postoperatively was observed.

High postoperative levels of P--5-HT seem to be related to low arterial Po₂ and pulmonary dysfunction. In 3 patients with complications a second increase in P-β-TG, P-TXB₂ and partly in P--5-HT was found. Platelets were temporarily refractory to ADP immediately following surgery and showed increased aggregabil-ity postoperatively. We conclude that platelets are activated in surgical stress.

Key words

Platelet activation - Surgical stress - Beta-thromboglobulin - Thromboxane - 5-hydroxytryptamine

• References

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