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ANESTHETIC PHARMACOLOGY

Sevoflurane Anesthesia Attenuates Adenosine Diphosphate-Induced P-Selectin Expression and Platelet-Leukocyte Conjugate Formation

Go-Shine Huang, MD^*, Chi-Yuan Li, MD MS^*, Ping-Ching Hsu, MS, Chien-Sung Tsai, MD, Tso-Chou Lin, MD^*, and Chih-Shung Wong, MD PhD^*

*Department of Anesthesiology and Division of Cardiovascular Surgery, Tri-Service General Hospital, National Defense Medical Center, National Defense University, Taipei, Taiwan, Republic of China

Address correspondence and reprint requests to Dr. Chi-Yuan Li, Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, 325 Cheng-Kung Rd., Section 2, Taipei, Taiwan, ROC. Address e-mail to cyli{at}ndmctsgh.edu.tw

The expression of P-selectin on the surface of platelets and platelet-leukocyte conjugate formation are considered to be an indicator of platelet activation and are important in thrombotic and inflammatory disease. Previous studies have reported the inhibitory effects of sevoflurane on platelet aggregation. We investigated whether sevoflurane alters the expression of P-selectin on platelets and the formation of platelet-leukocyte conjugates. Twenty-five patients undergoing minor extremity surgery received sevoflurane-based general anesthesia, with mask induction and laryngeal mask airway anesthesia maintenance. Whole blood was obtained before and 40 min after sevoflurane anesthesia. Unstimulated and adenosine diphosphate-stimulated samples of whole blood and platelet rich plasma were stained with fluorochrome-conjugated antibodies. The expression of P-selectin on platelets and the formation of platelet-leukocyte conjugates were measured using flow cytometry. Sevoflurane inhibited platelet P-selectin expression. It also reduced the formation of platelet-leukocyte conjugates, both in unstimulated and adenosine diphosphate-stimulated blood samples at 3%–4% end-expiratory sevoflurane concentrations used to maintain anesthesia.

IMPLICATIONS: Sevoflurane inhibited P-selectin expression of platelets in platelet rich plasma and whole blood, and reduced platelet-leukocyte conjugate formation ex vivo via flow cytometry analysis, which suggests modulation of platelet activation and platelet-leukocyte interaction.

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