Does surgical stress from elective cholecystectomy alter platelet function and activation?
Surgical stress during elective cholecystectomy leads to transient platelet activation and increased postoperative aggregability.
Ten patients for elective cholecystectomy were studied pre-, per-and postoperatively. All had neurolept anesthesia. Plasma concentrations of beta-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--beta-TG and P-TXB2 with postoperative normalization in 6 patients without complications. P--5-HT had a peak peroperatively 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--beta-TG, P-TXB2 and partly in P--5-HT was found. Platelets were temporarily refractory to ADP immediately following surgery and showed increased aggregability postoperatively. We conclude that platelets are activated in surgical stress.
Næsh et al. (Tue,) studied this question.
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