Comparison of pre-operative platelet functions by thromboelastogram in patients selective serotonin reuptake inhibitors user and non-user

BACKGROUND: The use of antidepressant drugs, in particular selective serotonin reuptake inhibitors (SSRIs), has increased in recent years. Using SSRIs can cause changes in serotonin metabolism. Serotonin provides platelet aggregation and plays a role in the regulation of vascular tone and coagulation processes. The aim of this study was to evaluate the effects of SSRI use on coagulation functions with thromboelastogram (TEG) in patients undergoing surgical operation and to compare with non-user cases.
METHODS: The study was designed for 60 patients whose physical status was classified according to the American Society of Anes-thesiology (ASA) classification as ASA I–II were included in the study. During routine pre-operative blood tests, 2 ml complete blood sample used and TEG performed. The cases were divided into two groups as SSRI user and non-user and analyzed.
RESULTS: R value was higher in SSRI user patients than in non-user patients. The MA value was significantly lower in SSRI user. There was no statistically significant difference in other parameters. In the evaluation based on duration of SSRI use, there was no statistically significant difference between those whose duration of use was more than 1 year and <1 year.
CONCLUSION: When the coagulation process was evaluated by TEG method, it was seen that the onset of clotting was prolonged and thrombus formation was slowed down in SSRI users. The results did not reveal that SSRI alone was the cause of bleeding, but it was concluded that slowing the process might be important, especially for surgical operations.

Seçici serotonin geri alým inhibitörü kullanan ve kullanmayan hastalarda ameliyat öncesi trombosit fonksiyonlarýnýn tromboelastogram ile karþýlaþtýrýlmasý

AMAÇ: Antidepresan ilaçlarýn, özellikle seçici serotonin geri alým inhibitörlerinin (SSRI’lar) kullanýmý son yýllarda artmýþtýr. SSRI’larý kullanmak se-rotonin metabolizmasýnda deðiþikliklere neden olabilir. Serotonin, trombosit agregasyonu saðlar, vasküler tonusun düzenlenmesinde ve pýhtýlaþma süreçlerinde rol oynar. Bu çalýþmanýn amacý cerrahi operasyon planlanan olgularda SSRI kullanýmýnýn pýhtýlaþma fonksiyonlarý üzerine etkilerini trom-boelastogram (TEG) ile deðerlendirmek ve kullanmayan olgularla karþýlaþtýrmaktýr.
GEREÇ VE YÖNTEM: Çalýþma, fiziksel durumu Amerikan Anesteziyoloji Derneði (ASA) sýnýflandýrmasýna göre ASA I-II olarak sýnýflandýrýlan 60 hasta için tasarlandý. Ameliyat öncesi hazýrlýk aþamasýnda rutin kan tetkiklerine ek olarak 2 ml tam kan örneði kullanýldý ve TEG analizi yapýldý. Hastalar SSRI kullanýcýsý ve kullanmayan olmak üzere iki gruba ayrýlarak incelendi.
BULGULAR: R deðeri SSRI kullanan grupta anlamlý olarak yüksek izlendi. SSRI kullanan grubun MA deðeri anlamlý olarak düþüktü. Diðer parametre-lerde istatistiksel olarak anlamlý bir fark yoktu. SSRI kullaným süresine göre yapýlan deðerlendirmede, kullaným süresi bir yýldan uzun ve bir yýldan az olanlar arasýnda istatistiksel olarak anlamlý bir fark yoktu.
TARTIÞMA: Tromboelastogram yöntemi ile pýhtýlaþma süreci deðerlendirildiðinde, SSRI kullananlarda pýhtýlaþma baþlangýcýnýn uzadýðý ve trombüs oluþumunun yavaþladýðý görüldü. Sonuçlar kanamanýn tek baþýna SSRI olduðunu ortaya koymadý, ancak sürecin yavaþlatýlmasýnýn özellikle cerrahi operasyonlar için önemli olabileceði sonucuna varýldý.