Alterations in fibrinolytic activity in 94 cases of oral surgery. Influence of stress
Saulnier, J.; Conard, J.; Horellou, M.H.; Schuhmann, C.; Samama, M.
Annales de Chirurgie 34(4): 290-296
1980
ISSN/ISBN: 0003-3944 PMID: 6446255 Document Number: 155790
In oral surgery a small number of hemorrhages remains unexplained as for their mechanisms. Alteration in the systemic fibrinolytic activity might be linked to physical, chemical or surgical stress in cases of minor oral surgery. To follow alterations in the fibrinolytic activity, blood samples were collected before, during and after operations performed in 94 patients. The fibrinolytic activity was evaluated using Fearnley-Gallimore's test. In 20 patients, fibrinogen-fibrin degradation products were measured without finding any modification. Local anesthesia without vasoconstrictor is rarely associated with an abnormal fibrinolytic activity. An enhancement of this activity is present in 44% of the cases operated under general anesthesia and in 60% of the cases undergoing a local anesthesia associating lidocaine with norepinephrine. Variations of fibrinolytic activity are statistically significant in this last group only. Among 5 patients with an abnormal lysis time in the post-operative period, abnormal bleeding was observed in 4 cases. An increase in fibrinolytic activity may play a role in the mechanism of some abnormal bleeding episodes in oral surgery.