Impact of desflurane versus sevoflurane on coagulation in radical cystectomy patients

Nermeen Mouhamed Zawam; Amel Abo Elela; Khalda Galal Radwan; Dalia Saad Abd Elkader; Norhan Abd El Alim Ali; Maha Abd Elbar Yousef; Mamdouh Roshdy; Bothayna Madkour

doi:10.53730/ijhs.v6nS5.10595

Authors

Nermeen Mouhamed Zawam Mcs of anesthesia and surgical ICU and pain management, Theodor Bilharz Research Institute, Egypt.
Amel Abo Elela Professor of anesthesia and surgical ICU and pain management, Faculty of Medicine, Cairo University, Egypt.
Khalda Galal Radwan Professor of anesthesia and surgical ICU and pain management, Theodor Bilharz Research Institute, Egypt.
Dalia Saad Abd Elkader Assistant professor of anesthesia and surgical ICU and pain management, Faculty of Medicine, Cairo University, Egypt.
Norhan Abd El Alim Ali Assistant professor of anesthesia and surgical ICU and pain management, Faculty of Medicine, Cairo University, Egypt.
Maha Abd Elbar Yousef Professor of anesthesia and surgical ICU and pain management, Theodor Bilharz Research Institute, Egypt.
Mamdouh Roshdy Professor of Urology, Theodor Bilharz Research Institute, Egypt.
Bothayna Madkour Professor of Haematology, Theodor Bilharz Research Institute, Egypt.

Keywords:

Desflurane, Sevoflurane, Coagulation, Radical Cystectomy, Thromboelastometry

Abstract

Background: Hypercoagulability in patients with cancer is difficult to detect through standard coagulation tests unless the platelet count and fibrinogen concentration is markedly increased. Reaching haemostasis during major surgical procedures is one of the most difficult problems which face anaesthesiologists. Objective: The aim of this study is to investigate the impact of desflurane in comparison to sevoflurane on coagulation detected by ROTEM to find out which of them is more suitable in reducing blood loss and better patient outcome after major surgery in the study population of patients. Patients and Methods: This study was conducted on thirty-six patients of both sexes having cancer bladder were admitted to Theodore Bilharz Research Institute (TBRI). They were randomly allocated into 2 groups (18 patients each). Group (S) received sevoflurane, while group (D) received desflurane as an inhalational anesthetic for Radical Cystectomy surgery. Six venous blood samples were collected for assessment of thromboelastometric parameters with INTEM, EXTEM, FIBTEM analysis which were CT (clotting time), CFT (clot formation time), α angle and MCF (maximum clot firmness).

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