Platelet function in surgical stress.

Ten patients for elective cholecystectomy were studied pre-, per-and postoperatively. All had neurolept anesthesia. Plasma concentrations of beta-TG, TXB2 and 5-HT and intraplatelet 5-HT were measured. Aggregation to ADP was recorded. Serum cortisol concentration was used as index of the stress response, showing peroperative increase and postoperative decrease. Closely related to this we observed a significant increase in P--beta-TG and P-TXB2 with postoperative normalization in 6 patients without complications. P--5-HT had a peak peroperatively and remained elevated postoperatively. A negative correlation between P--5-HT and decreasing intraplatelet 5-HT postoperatively was observed. High postoperative levels of P--5-HT seem to be related to low arterial PO2 and pulmonary dysfunction. In 3 patients with complications a second increase in P--beta-TG, P-TXB2 and partly in P--5-HT was found. Platelets were temporarily refractory to ADP immediately following surgery and showed increased aggregability postoperatively. We conclude that platelets are activated in surgical stress.