Effect of Local Fibrinogen Administration on Postoperative Bleeding in Open Prostatectomy Surgery

Abstract

BackgroundOpen prostatectomy is still accompanied by some postoperative bleeding. Prescribing fibrinogen to promote clot formation in patients with bleeding is of critical importance. This research studied the effects of local injection of fibrinogen on level of postoperative bleeding in open prostatectomy.MethodsOverall, 44 patients were randomly entered in a study on open prostatectomy. Patients in the intervention group received local injections of 500 mg fibrinogen (20 mL) dissolved in distilled water, and the control group patients only received 20 mL of normal saline, where the injections were given by the surgeon at the prostatectomy operation site. All patients were tested for hemoglobin, hematocrit, PT, PTT, INR, and fibrinogen level. Also, the amount of blood loss and requirement for blood products were recorded.ResultsThe study groups showed no difference regarding baseline variables. One patient in the fibrinogen group (1.66%) and four patients in the control group (6.66%) received blood products (P < 0.05), and the blood drainage tube at 24 hours after operation was 36.50) 18.70 (mL in the fibrinogen group and 151.36) 120.58 (mL in the control group (P = 0.005). There were no differences in hemoglobin, hematocrit, PT, PTT, INR, and serum fibrinogen level between the groups at any time.ConclusionsThe current study demonstrated that using fibrinogen in patients with high bleeding risk may effectively reduce the amount of bleeding and its subsequent blood transfusion requirement, after open prostatectomy surgery.

Clinical Applications of Aspirin as a Multi-potent Drug Beyond Cardiovascular Implications: A Proof of Concept for Anesthesiologists- A Narrative Review

“…However, the role of ASA in primary CVD prevention is challenging because of conflicting effects on CVD mortality rates (15). Mounting evidence suggests that the apparent benefits of ASA as a therapy modality for primary CVD prevention outweigh its less significant disadvantages causing the risk of some lifethreatening conditions such as bleeding (16)(17)(18)(19). A metaanalysis of 20 clinical cases including 3000 patients who received ASA as secondary cardiovascular prevention indicated that "aspirin resistance" in 28% of the patients correlated with a four-fold risk of CVD (20,21).…”