Effects Of Propofol On Platelet Activity In Patients With Coronary Atherosclerotic Heart Disease

Objective: Platelet function are related to coronary atherosclerotic heart disease.Patients with coronary atherosclerotic heart disease undergoing non-cardiovascular opertiaon are increasingly growing. More and more anesthesiatists are concerned how to decrease the possibility occurance of cardiovascular accidentity by using anesthesia techniques or drugs . So we tested the effects of continurous infusion of propofol on platelet activity in patients with coronary atherosclerotic heart disease and discuss it's proper mechanisiam.Methods:40 patients with coronary atherosclerotic heart disease underging celioscopic cholecystectomy opertiaon were randomly divided into two groups(n=20 each) (17men and 23women; weight range from 51 to 74; aged 57 ⁷5 yr .The diagnostic standard of CHD is standard of WHO which is announced in 1979.Patients with any of the following were excluded from the study: 1 diabetes mellitus, hypertension; 2 thrombocyte dysfunction and hepetic or renal dysfunction ; 3 use of nonsteroidal antiinflammatory drugs or antiplatelet drugs during the 14 days before operation. The patients were premedicated with atropine 0.5mg and Phenobarbital sodium 0.2g inmusclely 30 min before the operation .Entering into the operation room ,ECG,NIBP and SpO2 were measured. After an arm vein was cannulated for physiological saline solution and drugs's infusion,Tracheal intubation was done after intravenous- ly anesthetic induction. Anesthetic induction was done in groupâ… with midazolam 0.04mg/kg,propofol 2mg/kg,remifentanil 1μg/kg and vecuronium 0.1mg/kg. Anesthesia maintenance use propofol 3⁸mg.kg^-1.h^-1and remifentanil 0.2⁰.4μg.kg^-1.min^-1; Anesthesia induction was done in groupâ…¡with midazolam 0.1mg/kg,remifentanil 1μg/kg and vecuronium 0.1mg/kg. Anes- thetic maintenance use remifentanil 0.2⁰.4μg.kg^-1.min^-1.After endotracheal intubation,Ventilation was controlled with 8¹0ml /kg and a respiratory rate 12¹6/min. No use of inhalation anesthetic during the perioperation. And all of the patients received a 0.9% NaCl infusion during surgery.None received a colloid infusion or blood trasfusion. Blood was collected from she ancoal vein 10 minutes pre-induction,30minutes after propofol's continurous infusion and 120 minutes after the end of infusion for testing the function of PAGmax, GMP^-140,TXB2,PT and APTT .The turbidimetry was used to measured the rate of platelet aggregation on the platelet aggregation device. Using adenosine diphosphate (ADP) to induce the aggregation of platelet.Maximum intensity of aggregation was quantified as the maximum change in electric impedance 10 min after the inducer was added.Results :There was no difference about the common datas between the two groups such as weight,age and platelet amount.(P >0.050).In groupâ… , TXB2 at T₂ was significently lower than those at T₁ and T₃(P <0.05).There was no difference about TXB2 between T₁ and T₃(P >0.05).In groupâ…¡, There was no difference about TXB2 at T₁ ,T₂ ,T₃(P >0.05).There was no difference about TXB2 at T₁ and T₃ betweeen two groups(P>0.05).At T₂, TXB2 In groupâ… were statistically lower than Groupâ…¡(P <0.05). In groupâ… , GMP^-140 at T₂ was significently lower than those at T₁ and T₃(P<0.05).There was no difference about GMP^-140 between T₁ and T₃ (P >0.05).In groupâ…¡, There was no difference about GMP^-140 at T₁ ,T₂ ,T₃(P>0.05).There was no difference about GMP^-140 at T₁ and T₃ betweeen two groups (P>0.05).At T₂, GMP^-140 In groupâ… were statistically lower than Groupâ…¡(P <0.05).In groupâ… , PAGmax at T₂ was significently lower than those at T₁ and T₃(P <0.05). There was no difference about PAGmax between T₁ and T₃ (P>0.050).In groupâ…¡, There was no difference about PAGmax at T₁,T₂,T₃(P>0.05).There was no differences about PAGmax betweeen T₁ and T₃.At T₂, PAGmax In groupâ… were statistically lower than Groupâ…¡(P<0.05).There is no difference about PT and APPT at T₁,T₂and T₃ between two groups(P >0.05).Conclusion: Propofol can inhibit platelet activity.But it dosen't effect PT and APPT .So propofol combined anaesthesia are suitable for patients with coronary atherosclerotic heart disease for operations.