Abstract
Blood loss after total knee arthroplasty (TKA) is often associated with cardiovascular complications and a high transfusion rate of allogenic blood. In our study we focused our attention on developing a new intra-surgical procedure that appears safe, easy to perform and effective in the reduction of bleeding in TKA. We evaluated 84 patients who underwent TKA and met our inclusion criteria; they were assigned to two groups: 55 controls in which a saline solution was used to wash the surgical field before tourniquet release, and a second group of 29 patients, in which a saline solution containing a low dose of norepinephrine was locally applied before tourniquet release. The local administration of a low dose of norepinephrine has induced a significant reduction of perioperative blood loss and blood transfusion requirements; in addition, this method was characterised by the absence of complications or adverse effects. In conclusion, our data suggest that intraoperative local administration of a low dose of norepinephrine could represent an effective and safe method of reducing blood loss and preventing blood transfusions in patients with TKA.
Résumé
Les pertes sanguines après prothèse totale du genou sont souvent associées avec des complications cardio-vasculaires et nécessitent un pourcentage important de transfusions sanguines. Nous avons développé pour notre étude une technique chirurgicale destinée à réduire les saignements dans les prothèses totales du genou. Nous avons inclus 84 patients qui ont bénéficié d’une prothèse totale du genou. Nous les avons divisés en deux groupes: un groupe contrôle de 55 patients pour lesquels une solution saline a été utilisée pour laver le champ opératoire avant le lever du garrot et un second groupe de 29 patients pour lequel une solution saline contenant une faible dose de norépinéphrine a été localement appliquée avant l’ablation du garrot. L’administration locale d’une petite dose de norépinéphrine a entraîné une reduction significative du saignement péri-opératoire et de la nécessité de transfusion sanguine. Cette méthode n’a entraîné aucune complication. Conclusion, ces données nous incitent à suggérer que l’administration locale de deux petites doses de norépinéphrine représente une méthode de réduction du saignement et de prévention de la transfusion sanguine dans la mise en place d’une prothèse totale du genou.
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Gasparini, G., Papaleo, P., Pola, P. et al. Local infusion of norepinephrine reduces blood losses and need of transfusion in total knee arthroplasty. International Orthopaedics (SICO 30, 253–256 (2006). https://doi.org/10.1007/s00264-005-0050-2
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DOI: https://doi.org/10.1007/s00264-005-0050-2