Erythrocyte Rheology under Anesthesia: Insights from Glycated and Non-glycated Red Blood Cells

This study investigated the effects of general anesthesia (propofol, vecuronium, remifentanil, and their combinations) on the aggregation and viscoelasticity of human erythrocytes, in both normal and in vitro glycated samples (simulating hyperglycemia as occurs in diabetes). Our results demonstrate that these anesthetics increase erythrocyte aggregation. Propofol and its combinations show a synergistic effect, forming larger aggregates. Analysis of the erythrocyte viscoelasticity revealed that propofol alone increased the elastic modulus, while the propofol+remifentanil+vecuronium combination decreased the storage modulus, suggesting complex interactions with the cytoskeleton and lipid bilayer. In glycated erythrocytes, the same anesthetic combinations do not significantly affect viscoelastic parameters. The membrane viscosity values of glycated erythrocytes were closer to those of the control. These findings highlight that these drugs affect hemorheologic parameters differently in non-glycated and glycated erythrocytes. These results provide valuable insights for understanding potential microvascular complications in diabetic patients during and after surgical procedures. We suggest expanding the study to the molecular level for a more comprehensive understanding of the chemical interactions between the drugs used during general anesthesia and the erythrocyte membrane.