Comparison of hemostatic markers under different techniques for anesthesia-analgesia in total hip or knee replacement

Revista española de anestesiología y reanimación
E de la Fuente TorneroC Pascual Izquierdo

Abstract

Surgery promotes a state of hypercoagulability, predisposing to the possibility of postoperative thromboembolic complications. Our aim was to determine whether certain combinations of techniques (neuraxial, intravenous or both) for anesthesia and analgesia might be associated with attenuation of the prethrombotic state following total hip or knee replacement. Prospective longitudinal study of 45 patients undergoing elective hip or knee prosthetic surgery. The patients were randomized to 3 groups to receive different anesthesia-analgesia combinations: spinal-intravenous, spinal-epidural, or general-intravenous. From induction until 36 hours after surgery, we recorded the postoperative time course of the following markers of coagulation and fibrinolysis: platelet count; fibrinogen level; activated partial thromboplastin time; international normalized ratio; and levels of prothrombin activation fragments 1 and 2, thrombin-antithrombin III complex, and D-dimer. No statistically significant between-group differences were found in patient demographic, clinical, surgical or postoperative data. No symptomatic thromboembolic complications or deaths were recorded in the 30 days after surgery. Statistically significant differences were fo...Continue Reading

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