The majority of anesthetic agents, including inhalation anesthetics, inhibit platelet function, but the effect of propofol on platelets is controversial. This study was designed to compare the effects of propofol-remifentanil total intravenous anesthesia and sevoflurane inhalation anesthesia on platelet function.

Patients undergoing major hip surgery were divided into two groups: inhalation anesthesia with sevoflurane or total intravenous anesthesia with propofol and remifentanil. Hemoglobin, hematocrit, platelet count, prothrombin time, activated partial thromboplastin time, and platelet aggregation were measured 5 minutes before induction, the first hour intra-operatively, and the first hour postoperatively.

Total intravenous anesthesia with propofol and remifentanil significantly diminished collagen-induced platelet aggregation values intraoperatively compared with preoperative values. Also, intraoperative collagen- and adenosine diphosphate (ADP)-induced platelet aggregation was significantly lower in anesthesia with propofol and remifentanil compared with sevoflurane anesthesia. Sevoflurane did not induce significant changes in collagen- or ADP-induced platelet aggregation.

Total intravenous anesthesia with propofol and remifentanil significantly reduced collagen-induced platelet aggregation intraoperatively, while inhalation anesthesia with sevoflurane did not reduce collagen-or ADP-induced platelet aggregation at all.