COMPARATIVE STUDY BETWEEN THE EFFECT OF PROPOFOL ANESTHESIA VERSUS ISOFLURANE ANESTHESIA ON PLATELET FUNCTION AND FIBRINOLYTIC RESPONSE FOR TOTAL HIP ARTHROPLASTY

Total hip replacement is associated with moderate surgical trauma leads to systemic changes in hemostasis. Hematological changes activated by surgery may increase intraoperative and postoperative blood loss. The purpose of this study was designed to study the effect of propofol infusion versus isoflurane on platelet function, fibrinolysis and perioperative blood during total hip arthroplasty by assay of thromboelastography and fibrinolytic indices [D-Dimers and fibrin degradation product (FDP)]. Patients and methods: In a randomized, controlled study 40 patients were studied during perioperative period of primary unilateral total hip replacement and classified into two equal groups. Patients received either propofol infusion (group I) or isoflurane (group II) for maintenance of general anesthesia. Results: The demographic characteristics of the two groups were comparable and in significant statistically, blood loss, intravenous fluid needs and blood transfusion are higher in group I than isoflurane group and also D-dimers, FDPs was significantly higher in group I compared to group II at the end of the operation (T1). Mean values of thromboelstography at (propofol group) at T1 shows that there was significant rise as regards R time, while K time not significantly affected and MA (maximum amplitude), significantly decreased than T0 which reflect effect of propofol on platelets function. Conclusion: The results of this study demonstrated that, propofol anesthesia was associated with statistically significant increased of fibrinolytic activity, blood loss, blood transfusion needs, and also inhibition of platelet aggregation, in comparison with isoflurane anesthesia.