Preservation of platelet function during trimethaphan infusion

The effect of trimethaphan (Arfonad) infusion on platelet function was prospectively evaluated in 38 (n = 38) patients (28 patients receiving trimethaphan, ten control patients) undergoing elective cardiac surgery. Any patient with a positive history for the ingestion of medication known to interfere with platelet function was excluded from the study. Following induction of anesthesia with fentanyl (and prior to cardiopulmonary bypass) 28 patients (n = 28) received trimethaphan as clinically indicated to maintain a mean blood pressure of 80 mmHg. The infusion rate and total dose of trimethaphan delivered was recorded for each patient. The evaluation of platelet function was performed via adenosine diphosphate (ADP) and epinephrine-induced platelet aggregation tests. The administration of trimethaphan failed to result in any detrimental effect on platelet function as assessed via these aggregation studies. Template bleeding times were also performed on all study patients. Bleeding time measurements performed in patients following trimethaphan administration were unchanged from baseline values. Platelet aggregation studies and bleeding time performed in control group following the administration of fentanyl (30 micrograms/kg) plus enflurane (inspired concentration 0.5-1%) did not reveal any deviation from baseline values. These results are in contrast to a previous study that demonstrated a negative effect upon platelet function following sodium nitroprusside administration (at clinically acceptable doses). These data demonstrate that trimethaphan provides control of arterial pressure with preservation of platelet function.