Influence of Intraoperative Blood Salvage on Surgery for Scoliosis

Abstract

Objective: To evaluate the effectiveness of intraoperative blood salvage (IBS) in reducing allogeneic transfusion in patients undergoing surgery for scoliosis. Methods: Retrospective case-control study with 69 patients who underwent surgical treatment for scoliosis correction from August 2008 to December 2014 in a teaching hospital. We used the IBS in 43 patients and it was not used in 26. The groups were compared according to the medical records, and the data were processed on SPSS 20.0. For the associations between the variable IBS and non-IBS and the independent variables we applied the χ 2 and the likelihood ratio tests, and the strength of which was calculated by their 95% CI. The means were compared by Student's t and Mann-Whitney tests. The confidence level was 0.05. Results: There were no significant differences between groups with the variables age, sex, preoperative weight, postoperative blood drainage and surgical time. There was a significant reduction of intraoperative allogeneic transfusion in the IBS group submitted to posterior arthrodesis compared with the control group, with no difference in the transfusion of red blood cells between the two groups postoperatively. In the 24 patients who underwent combined arthrodesis, there was no significant difference in allogeneic transfusion in the intra-and postoperative periods between the groups. Conclusion: The system proved to be effective in reducing allogeneic transfusion during surgery in patients undergoing posterior arthrodesis for scoliosis, but it was not effective in reducing allogeneic transfusion in the intra-and postoperative periods of those undergoing combined arthrodesis.Keywords: Spinal fusion; Scoliosis; Blood transfusion, autologous; Operative blood salvage; Erythrocytes. RESUMO

The Use of Antifibrinolytics in Hip Trauma Surgery in a Public Health System: A Prospective Study

“…The usage of tranexamic acid (TXA), and ɛ-aminocaproic acid (EACA) antagonize fibrinolytic activity, and therefore reduce the amount of lost blood. [4][5][6][7] Studies have been demonstrating that the use of these medications in patients who had undergone orthopedic surgery, has led to a significant reduction in the total blood loss, without the increase of thromboembolic events. 6,8 However, research comparing the cost-effectiveness between these two drugs are limited in hip trauma surgery.…”