Perioperative effects of desflurane versus propofol on hemostasis guided by thromboelastometry in splenectomy with liver cirrhosis

Figures & data

Table 1. Demographic data, etiology of cirrhosis, preoperative hemodynamics, ASA classification and duration of surgery.

	Group D(n=15)	Group P(n=15)	P-value
Age (yrs.) Gender	48.87 ± 3.54	48.73 ± 5.13	0.935
Female	4 (26.7%)	5 (33.3%)	1.000
Male	11 (73.3%)	10 (66.7%)
Weight (kg)	79.87 ± 4.85	79.20 ± 4.62	0.703
Height (cm)	159.87 ± 5.45	163.33 ± 5.07	0.082
BMI (kg/m2)	31.05 ± 1.89	29.71 ± 1.98	0.069
ASA-physical status
II	12 (80.0%)	13 (86.7%)	1.000
III	3 (20.0%)	2 (13.3%)
Etiology of cirrhosis
HCV	11 (73.3%)	12 (80.0%)	1.000
Bilharzial	4 (26.7%)	3 (20.0%)
Surgical time (min)	161.00 ± 22.06	158.67 ± 27.22	0.798
MBP (mmHg)	74.33 ± 4.72	73.80 ± 3.86	0.737
HR (bpm)	83.13 ± 5.07	82.93 ± 5.18	0.916

Data are expressed as mean ± SD or number (%). D; patients anesthetized with desflurane, P; patients anesthetized with propofol, BMI; body mass index, ASA; American Society of Anesthesiology Classes, HCV; Hepatitis C Virus, MBP: mean blood pressure. HR: heart rate. Bpm: beat per minute. P > 0.05 = not significant.

Table 2. Levels of Hb, WBCs and platelets.

	Preoperative	After ligation	Postoperative	First POD	Third POD	One month
Hb (g/dl)
Group D	11.49 ± 0.47	10.36 ± 1.32*	10.58 ± 1.00*	10.43 ± 1.63*	10.28 ± 1.79*	11.39 ± 1.14
Group P	11.38 ± 1.83	10.53 ± 0.91*	10.5 ± 1.12	10.41 ± 1.86	10.31 ± 1.62*	11.48 ± 1.14
WBCs (cell/mcl)Group D	4.11 ± 1.95	6.84 ± 2.32*	8.78 ± 1.74*	9.63 ± 1.16*	8.17 ± 1.54*	6.62 ± 1.15*
Group P	4.33 ± 1.92	6.69 ± 2.58*	8.65 ± 1.50*	9.65 ± 0.75*	8.39 ± 1.61*	6.75 ± 1.34*
PLT (cell/mcl)Group D	69.2 ± 23.21	87.87 ± 37.36	109.20 ± 67.1*	140.07 ± 74.76*	173.93 ± 65.25*	194.53 ± 22.88*
Group P	68.07 ± 21.09	87.73 ± 31.02*	89.40 ± 25.23*	110.40 ± 29.66*	172.33 ± 55.11*	195.73 ± 48.66*

Data are expressed as mean ± standard deviation. D; patients anesthetized with desflurane, P; patients anesthetized with propofol. PLT: platelets. WBCs: white blood cells, Hb: hemoglobin, POD: postoperative day.

* P < 0.05 relative to preoperative (baseline) within the same group.

Table 3. Results of INR, PT and PTT.

	Preoperative	After ligation	Postoperative	First POD	Third POD	One month
INR
Group D	1.15 ± 0.05	1.17 ± 0.09	1.19 ± 0.04*	1.17 ± 0.09	1.14 ± 0.15	1.08 ± 0.11*
Group P	1.16 ± 0.06	1.21 ± 0.03*	1.2 ± 0.10*	1.18 ± 0.05	1.15 ± 0.05	1.13 ± 0.05
PT (Sec)
Group D	13.07 ± 1.48	13.21 ± 1.21	14.11 ± 0.58*	13.29 ± 1.01	12.51 ± 0.97	12.01 ± 0.76*
Group P	13.38 ± 1.25	13.43 ± 1.16	14.07 ± 0.71*	13.32 ± 1.06	12.88 ± 0.73*	10.62 ± 3.85*
PTT (Sec)
Group D	32.63 ± 1.61	33.04 ± 3.28	33.43 ± 4.44	34.39 ± 4.13	32.56 ± 4.06	29.93 ± 2.34*
Group P	13.38 ± 1.25	13.43 ± 1.16	14.07 ± 0.71*	13.32 ± 1.06	12.88 ± 0.73*	10.62 ± 3.85*

Data are expressed as mean ± standard deviation. D; patients anesthetized with desflurane, P; patients anesthetized with propofol. POD: postoperative day, INR: international normalized ratio, PT: prothrombin time, PTT: partial thromboplastin time.

* P value < 0.05 compared to preoperative level in each group.

Table 4. Results of P-selectin/CD62P, Fibrinogen and D-Dimer.

	Preoperative	After ligation	Postoperative	First POD	Third POD	One month
P-Selectin/CD62P (ng/ml)
Group D	18.29 ± 3.77	17.72 ± 2.65	19.25 ± 3.51	21.98 ± 5.16*	25.28 ± 5.41*	22.84 ± 2.82*
Group P	18.81 ± 3.21	18.25 ± 1.97	17.90 ± 2.01	19.95 ± 1.61	23.87 ± 3.27*	23.46 ± 3.06*
Fibrinogen (g/l)						2.48 ± 0.65*
Group D	2.01 ± 0.33	2.20 ± 0.30	2.11 ± 0.30	2.13 ± 0.44	2.45 ± 0.53*	2.48 ± 0.65*
Group P	2.10 ± 0.34	2.06 ± 0.23	2.02 ± 0.40	2.01 ± 0.40	2.55 ± 0.57*	2.43 ± 0.56
D-Dimer (μg/ml)
Group D	0.56 ± 0.23	0.85 ± 0.22*	0.76 ± 0.21*	0.71 ± 0.23	0.63 ± 0.21	0.56 ± 0.16
Group P	0.61 ± 0.20	0.84 ± 0.25*	0.82 ± 0.23*	0.78 ± 0.26	0.79 ± 0.26	0.60 ± 0.16

Data are expressed as mean ± standard deviation. D; patients anesthetized with desflurane, P; patients anesthetized with propofol. POD: postoperative day.

* P value < 0.05 compared to preoperative level in each group.

Table 5. Results of EX-TEM, IN-TEM and FIB-TEM; CT, CFT, MCF and α- angle.

	Preoperative	After ligation	Postoperative	First POD	Third POD	One month
P-Selectin/CD62P (ng/ml)
EX-TEMCT (Sec)
Group D	50.33 ± 8.15	50.33 ± 6.00	53.60 ± 8.04*	50.00 ± 2.48	50.07 ± 7.12	49.20 ± 5.98
Group P	53.53 ± 5.08	53.47 ± 4.07	54.07 ± 5.68	53.07 ± 7.08	51.93 ± 6.88	51.60 ± 4.53
CFT (Sec)
Group D	115.73 ± 7.63	120.67 ± 7.66	127.53 ± 10.13*	121.73 ± 5.86*	121.73 ± 5.86*	114.4 ± 5.73
Group P	116.47 ± 5.36	122.73 ± 7.45*	129.47 ± 12.94*	124.13 ± 5.33*	120.8 ± 5.73*	117.33 ± 4.06
MCF (mm)
Group D	54.60 ± 3.74	57.47 ± 4.10	52.53 ± 5.79	59.60 ± 5.40	63.60 ± 6.49*	67.13 ± 5.9*
Group P	54.53 ± 4.76	54.53 ± 4.76	51.27 ± 3.90	58.93 ± 5.50*	63.2 ± 5.31*	66.47 ± 3.29*
α angle (o)
Group D	69.80 c 5.41	69.33 ± 5.37	67.27 ± 4.56	70.07 ± 5.16	70.47 ± 3.18	71.60 ± 1.72
Group P	69.67 ± 3.5	69.13 ± 4.42	67.07 ± 4.5	69.53 ± 2.95	70.40 ± 4.29	71.0 ± 4.61
IN-TEMCT (Sec)
Group D	161.93 ± 5.35	174.53 ± 16.19*	188.8 ± 11.8*	177 ± 93 ± 9.88*	169.33 ± 9.13*	164.4 ± 8.42*
Group P	161.33 ± 8.89	177.93 ± 9.88*	189.53 ± 10.67*	178.6 ± 12.13	171.47 ± 10.28*	168.07 ± 9.54*
CFT (Sec)
Group D	87.73 ± 8.79	89.47 ± 4.97	89.8 ± 4.75	79.93 ± 10.61	77.33 ± 2.23*	69.8 ± 7.36*
Group P	86.13 ± 4	90.13 ± 4.42*	90.8 ± 5.31*	85.13 ± 5.99	78.13 ± 4.0*	71.13 ± 6.29*
MCF (mm)
Group D	58.53 ± 4.44	57.47 ± 4.1	55.13 ± 3.52*	63.67 ± 6.99*	67.2 ± 5.07*	67.8 ± 3.05*
Group P	58.27 ± 4.11	55.47 ± 6.15	55.2 ± 3.73	60.0 ± 8.4	63.33 ± 51*	65.27 ± 4.06*
α angle (o)
Group D	75.4 ± 2.5	75.33 ± 3.18	75.0 ± 1.81	75.53 ± 3.07	77.27 ± 2.76*	78.6 ± 1.5*
Group P	75.13 ± 3.44	74.47 ± 3.02	74.4 ± 1.68	75.2 ± 3.28	77.2 ± 2.01	77.07 ± 2.89
FIB- TEM)	MCF (mm)
Group D	15.73 ± 2.81	15.67 ± 3.35	12.8 ± 3.88*	I6.4 ± 4.19	19.2 ± 5.03*	20.13 ± 2.92*
Group P	15.6 ± 2.95	15.6 ± 3.64	14.0 ± 1.56	16.33 ± 3.99	19.0 ± 2.1*	19.93 ± 2.96*

Data are expressed as mean ± standard deviation. D; patients anesthetized with desflurane, P; patients anesthetized with propofol. POD: postoperative day, CT: clotting time, CFT: clot formation time. MCF: maximum clot firmness.

* P value < 0.05 compared to preoperative level.