Department of Anaesthesia & Intensive Care, University Hospital, Linkoping, Sweden.
Eur J Anaesthesiol. 2011 May;28(5):363-9. doi: 10.1097/EJA.0b013e32834448ed.
The risk/benefit of continuing low-dose acetylsalicylic acid (aspirin) for secondary prevention in the perioperative period is still debated. The primary aim of this study was to determine the effect of acetylsalicylic acid compared with placebo on platelet function in the perioperative period.
This is a subgroup analysis of a randomised, double-blind, placebo-controlled multicentre study. High-risk patients undergoing major non-cardiac surgery were randomised to 75 mg acetylsalicylic acid or placebo 7 days preoperatively, until the third postoperative day. In 36 patients, platelet function in response to arachidonic acid was assessed by whole-blood impedance aggregometry using a multiplate analyser 1 h before surgery, directly after surgery and 48 h postoperatively.
The platelet function was significantly reduced in patients treated with acetylsalicylic acid compared with placebo in the preoperative period [200 aggregation units (AU) min (interquartile range [IQR] 133-261 AU min⁻¹) vs. 860 AU min (IQR 800-1010 AU min), P < 0.001] as well as postoperatively [198 AU min (IQR 138-270 AU min) vs. 605 AU min (IQR 434-836 AU min), P < 0.001]. The platelet response was significantly reduced postoperatively compared with preoperatively in patients receiving placebo [860 AU min (IQR 800-1010 AU min) vs. 605 AU min (IQR 434-861 AU min), P = 0.0009]. No significant differences were found between pre- and postoperative platelet function in patients on acetylsalicylic acid [200 AU min (IQR 133-261 AU min) vs. 198 AU min (133-270 AU min), P = 0.21].
Multiplate whole-blood impedance aggregometry demonstrates acetylsalicylic affect in preoperative as well as postoperative samples derived from patients undergoing non-cardiac surgery.
在围手术期继续低剂量乙酰水杨酸（阿司匹林）进行二级预防的风险/获益仍存在争议。本研究的主要目的是确定与安慰剂相比，乙酰水杨酸对围手术期血小板功能的影响。
这是一项随机、双盲、安慰剂对照的多中心研究的亚组分析。高危患者行非心脏大手术，术前 7 天随机给予 75mg 乙酰水杨酸或安慰剂，直至术后第 3 天。在 36 例患者中，使用多板分析仪在术前 1 小时、术后即刻和术后 48 小时通过全血阻抗聚集法评估花生四烯酸诱导的血小板功能。
与安慰剂相比，术前接受乙酰水杨酸治疗的患者血小板功能明显降低[200 聚集单位（AU）min（四分位距[IQR]133-261 AU min⁻¹）vs. 860 AU min（IQR 800-1010 AU min），P<0.001]以及术后[198 AU min（IQR 138-270 AU min）vs. 605 AU min（IQR 434-836 AU min），P<0.001]。接受安慰剂治疗的患者术后血小板反应明显低于术前[860 AU min（IQR 800-1010 AU min）vs. 605 AU min（IQR 434-861 AU min），P=0.0009]。接受乙酰水杨酸治疗的患者术前和术后血小板功能无显著差异[200 AU min（IQR 133-261 AU min）vs. 198 AU min（IQR 133-270 AU min），P=0.21]。
多板全血阻抗聚集法显示，阿司匹林在非心脏手术患者的术前和术后样本中均有影响。
