Preparation for regional anaesthesia induces changes in thrombelastography

Area of Science:

• Anesthesiology
• Hematology
• Obstetrics

Background:

• Thrombelastography (TEG) studies on fluid infusions and coagulation present conflicting results.
• Environmental factors are hypothesized to contribute to disparities in previous research.

Purpose of the Study:

• To investigate the effects of Gelofusine colloid infusion on coagulation parameters measured by TEG.
• To assess whether moderate hemodilution induces hypercoagulability.
• To explore the role of environmental factors in TEG findings.

Main Methods:

• Two groups of 20 women undergoing elective Cesarean section were studied.
• Group 1 received 500 ml Gelofusine infusion over 15 minutes, with TEG analysis before and after.
• Group 2 served as a control without fluid infusion, undergoing identical TEG analysis.

Main Results:

• Significant changes in r and k values were observed in both the infusion and control groups, indicating enhanced coagulation.
• Hypercoagulable changes were present even in the group that did not receive fluid preload.
• These findings challenge the hypothesis that moderate hemodilution alone causes hypercoagulability.

Conclusions:

• Moderate hemodilution may not be the primary driver of hypercoagulability observed in some studies.
• Environmental factors likely play a significant role in modulating coagulation responses measured by TEG.
• Discrepancies between in vivo and in vitro TEG studies may be attributable to environmental influences.