The Journal of arthroplasty
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Randomized Controlled Trial Clinical Trial
Aprotinin (Trasylol) does not reduce bleeding in primary total hip arthroplasty.
This is a randomized, double-blind, controlled study of the effects of aprotinin (Trasylol) during primary total hip arthroplasty. Sixty patients were randomized to receive either 1.5 x 10(6) KIU of aprotinin or a similar volume of normal saline as a bolus preoperatively. Blood loss was measured from the femoral canal at the time of surgery. ⋯ There was no significant difference between the groups in terms of total blood loss, postoperative hemoglobin, or transfusion requirement. In the group that received aprotinin, there was a trend toward reduced blood loss from the femoral canal, but this was not statistically significant. The results of this study do not support the routine use of aprotinin in primary total hip arthroplasty.
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Complications after spinal or epidural anesthesia are rare. We report 2 cases of postoperative, complete paraplegia after regional anesthesia in orthopaedic patients not on anticoagulants. ⋯ A review of the literature regarding complications of regional anesthesia is presented. Regional anesthesia should be administered with caution and in selected patients.