Effect of ketorolac, bupivacaine and low-dose heparin on thrombelastographic variables in vitro

We have studied the effects of ketorolac, bupivacaine and low-dose heparin on three thrombelastographic (TEG) variables (r, alpha, MA) in vitro. Blood samples were obtained from 12 healthy volunteers and 88 ASA I-II elective surgical patients. Clinically relevant concentrations of ketorolac (4.1 micrograms ml-1) and bupivacaine (2.7 micrograms ml-1) had little or no effect on the TEG variables. However, low concentrations of heparin (0.07-0.28 u. ml-1) had marked effects on all three TEG variables. Thus the interpretation of TEG abnormalities during anaesthesia and surgery may be confounded by the presence of heparin, but not by clinical concentrations of ketorolac or bupivacaine.