Changes in Plasma Levels of Vasoactive Factors in Patients Undergoing Abdominal Surgery


Background: To investigate the changes in plasma levels of endothelin (ET), nitric oxide (NO), prostacyclin (PGI2) and thromboxane A2 (TXA2) in patients undergoing abdominal operation. Materials and Methods: Thirty cases of abdominal surgery (14 males, 16 females; mean age 48 ± 11 years, ranging from 24 to 70) were prospectively recruited: Twenty-four cases of cholelithiasis and cholecystitis, 2 cases of peptic ulcer and 4 cases of portal vein hypertension. At five different time points (1-3 days after hospitalization (T1), at surgery beginning, after anesthesia (T2) and at the first (T3), third (T4) and fifth day (T5) after surgery), plasma levels of ET-1, NO2-, NO3-6-keto-PGF1α and thromboxane B2 (TXB2), the latter two being stable metabolites of PGI2 and TXA2 respectively, were measured. Results: ET-1 levels increased significantly after anesthesia and surgery (T1 = 69.2 ± 10.7 vs. T2 = 82.4 ± 14.7 vs. T3 = 96.6 ± 22.8 pg/ml, p < 0.05). TXB2 levels before surgery were significantly lower than that after (T2 = 67.5 ± 52.7 vs. T3 = 157.6 ± 21.8 pg/ml, p < 0.05). Pre-surgery NO levels were significantly higher than that after surgery (T1 = 2575 ± 50 vs. T2 = 1922 ± 44 vs. T3 = 1692 ± 39 ng/ml, p < 0.05 for T1 vs. T2 and T3). Pre-surgery levels of 6-keto-PGI1α were significantly higher than that after anesthesia and surgery (T1 = 180.5 ± 17.8 vs. T2 = 132.1 ± 32.6 vs. T3 = 110.9 ± 31.9 pg/ml, p < 0.05 for T1 vs. T2 and T3). Conclusions: Level of vasoconstrictive factors (ET and TXA2) increased significantly after surgery, while vasodilatory factors (NO and PGI2) decreased significantly after operation. Imbalance in vasoactive factors encourages hypercoagulability and then may play a role in the pathobiology of post-surgery complications, such as deep venous thrombosis (DVT).

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Zhang, J. , Li, M. and Zhang, F. (2014) Changes in Plasma Levels of Vasoactive Factors in Patients Undergoing Abdominal Surgery. Surgical Science, 5, 389-396. doi: 10.4236/ss.2014.59063.

Conflicts of Interest

The authors declare no conflicts of interest.


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