Observation of coagulation change during induced hypotensive anesthesia and autologous plasma transfusion

Coagulation change was studied in 16 adult female patients undergoing radical hysterectomy with BPLND surgery. None had preoperative alterations in coagulation or liver function and was receiving anticoagulant or antiplatelet medication. Sixteen ASA class I-II were divided into 2 groups randomly with eight patients in each group. One group accepted autologous plasma transfusion near the end of surgery, the other group did not. Autologous plasma was retrieved by plasma saver post induction of anesthesia. Every patient received induced hypotensive anesthesia during the operation. Whole blood coagulation status was quantitated by using thromboelastography (TEG). Blood samples for TEG were obtained before induction of anesthesia, after closure of peritoneum, and 2 hours post autologous plasma transfusion or 2 hours post peritoneum closure. Most parameters measured by TEG showed improved coagulation status in autologous plasma transfusion group. We concluded that coagulation change was minimal during induced hypotension, and improved coagulation was obtained 2 hours post autologous plasma transfusion during radical hysterectomy with BPLND surgery.