• Int J Artif Organs · Jan 1999

    Randomized Controlled Trial Clinical Trial

    Reducing perioperative blood loss in patients undergoing total hip arthroplasty.

    • A D'Ambrosio, B Borghi, A Damato, G D'Amato, D Antonacci, and F Valeri.
    • 1st Service of Anaesthesia and Intensive Care, I.R.C.C.S. Casa Sollievo Della Sofferenza Hospital, S. Giovanni Rotondo (Foggia), Italy.
    • Int J Artif Organs. 1999 Jan 1; 22 (1): 47-51.

    AbstractIn this prospective, randomised, double-blind study, we investigated the effect of epidural anaesthesia and an antifibrinolytic agent, Aprotinin (500,000 KIU in bolus before surgery and 500,000 KIU h(-1) in drip form during surgery), on intra and postoperative blood loss and transfusion requirements in total hip arthroplasty. Sixty patients were allocated randomly to four groups (A: epidural + general anesthesia + Aprotinin, B: epidural + general anesthesia + placebo (equal volume), C: general anaesthesia + Aprotinin, D: general anaesthesia + placebo). Postoperative analgesia: epidural analgesia in groups A and B, systemic analgesia with opiates in groups C and D. Blood loss during surgery was monitored and salvaged with the Compact-A Dideco, and postoperative blood loss with the BT 797 Recovery Dideco for the first 24 hours. Perioperative blood loss, frequency and quantity of transfusions were significantly higher in group D (p<0.0001). Total blood loss was reduced by 31.3% by epidural anaesthesia, 20.4% by Aprotinin and 51.4% using a combination of the two techniques.

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