Comparative study of impact of isoflurane and sevoflurane anaesthesia on the perioperative hemostatic response during open and laparoscopic surgeries

Abstract

The normal hemostatic response to vascular damage depends on closely linked interaction between the blood vessel wall, circulating platelets and blood coagulation factors. Coagulation begins almost after an injury to the blood vessel that damaged the endothelial lining of the vessel. Platelets immediately form a plug at the site of injury; this is called primary hemostasis. Secondary hemostasis occurs simultaneously when plasma proteins, (coagulation factors) respond in a complex cascade to form fibrin strands, which strengthen the platelet plug.. Soluble platelet-selectin (sP-selectin) is an indicator of platelet activation, fibrinogen (FIB) level is a reflection of clotting ability in the body, and Von Willebrand factor (vWF) is essential for normal thrombus formation.. Antithrombin (AT) rapidly neutralizes the thrombin generated to form inactive thrombin-antithrombin complex (TAT) which is a sensitive marker of activation of coagulation and thrombin generation. Protein C is a major physiological anticoagulant which acts with its cofactor protein S to inactivate factor Va and factor VIIIa. When a clot is formed, plasminogen changes into plasmin which degrades fibrinogen and fibrin to produce fibrin degradation products (FDPs) D-dimer and respectively. D-dimer is the final product of the simultaneous activation of blood coagulation and fibrinolysis. There is an extensive cross-talk between