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Eur J Orthop Surg Tr · Jul 2015
Eliminating the use of allogeneic blood products in adolescent idiopathic scoliosis surgery.
- Mark J Berney, Peter H Dawson, Margaret Phillips, Darren F Lui, and Paul Connolly.
- Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland, markjberney@gmail.com.
- Eur J Orthop Surg Tr. 2015 Jul 1; 25 Suppl 1: S219-23.
PurposeThe aim of this study was to compare transfusion requirements in patients before and after the introduction of tranexamic acid as standard in patients undergoing spinal surgery for idiopathic scoliosis in a national orthopaedic hospital.MethodsA retrospective chart review of 56 idiopathic scoliosis patients who underwent posterior spinal instrumentation and fusion between 2009 and 2013 at our institution. Preoperative, intraoperative, and postoperative data were measured.ResultsPatients who received tranexamic acid as standard (n = 31) showed a trend towards a decrease in transfusion requirements compared with those who received no tranexamic acid (n = 25). These patients had a statistically significant decrease in operative time (223 vs 188 min, p = 0.005), and estimated intraoperative blood loss was reduced by nearly 50% in the tranexamic acid group. They also had an associated reduced decrease in haemoglobin between preoperative and postoperative levels (4 vs 5 g/dL, p = 0.01).ConclusionsSince February 2012, no patient has required intraoperative or postoperative allogeneic blood product transfusion in this hospital. The routine use of antifibrinolytic medications in patients undergoing surgery for adolescent idiopathic scoliosis has effectively eliminated the need for allogeneic blood products.
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