A randomized trial of the effect of low dose epinephrine infusion in addition to tranexamic acid on blood loss during total hip arthroplasty

British Journal of Anaesthesia
Ø JansP I Johansson

Abstract

Total hip arthroplasty (THA) is associated with both intraoperative and postoperative blood loss resulting in anaemia and, in some patients, transfusion of red blood cells. Epinephrine enhances coagulation by several mechanisms. We evaluated the effect of intraoperative low dose infusion of epinephrine on intraoperative and early postoperative blood loss. After consent, 106 subjects undergoing THA under spinal anaesthesia were randomly assigned to receive an i.v. infusion of either epinephrine 0.05 µg kg(-1) min(-1) or placebo (saline 0.9%) during the entire surgical procedure. Intraoperative tranexamic acid (TXA) was administered to all subjects. The primary outcome was intraoperative blood loss directly measured by drains and weighing swabs. Secondary outcome was total blood loss at 24 h postoperatively calculated using the Gross formula. Of 106 subjects randomized, 6 were excluded, leaving 100 subjects for analyses. Mean duration of surgery was 58 (21) min. Intraoperative blood loss was 343 (95% CI 300-386) ml in the epinephrine group compared with 385 (353-434) ml in the placebo group, P = 0.228. 24 h blood loss was 902 (800-1004) ml in the epinephrine group compared with 1080 (946-1220) ml in the placebo group, P = 0.038. ...Continue Reading

References

Mar 1, 1983·Anesthesiology·J B Gross
Feb 13, 2001·European Journal of Haematology·R von Känel, J E Dimsdale
Oct 30, 2010·Vox Sanguinis·Ø JansP I Johansson
Jan 25, 2011·The Journal of Arthroplasty·Xudong LiuBingfang Zeng
Apr 11, 2012·Anesthesiology·Lawrence Tim Goodnough, Aryeh Shander
May 25, 2012·The Journal of Bone and Joint Surgery. American Volume·Zhi-Gao YangLi-Dong Wu
May 26, 2012·British Journal of Anaesthesia·A ShanderD R Spahn
Dec 12, 2012·Clinical Physiology and Functional Imaging·Darija BakovicZeljko Dujic
Apr 26, 2013·Archives of Orthopaedic and Trauma Surgery·Xin-die ZhouLi-dong Wu
May 11, 2013·British Journal of Anaesthesia·E OrtmannA A Klein

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Citations

May 31, 2018·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Yuangang WuBin Shen
Aug 21, 2019·Journal of Orthopaedic Surgery and Research·Federico PennestrìGiuseppe M Peretti
Apr 11, 2018·Anesthesiology and Pain Medicine·Seyed Mohammad Reza GoushehShahrzad Pooyan

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