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2018, Number 3

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Cir Cir 2018; 86 (3)

Use of ethamsylate to reduce postoperative bleeding and transfusion index in total hip arthroplasty. A randomized clinical trial

Ramos-Sánchez TA, Ramos-Morales T, Morales-Avalos R, Blázquez-Saldaña J, Peña-Martínez VM, Vílchez-Cavazos F

Language: Spanish
References: 16
Page: 270-276
PDF size: 273.05 Kb.


ABSTRACT

Background: Secondary bleeding is one of the leading causes of morbidity after the surgery. Ethamsylate has been used with good results to decrease bleeding in various pathologies such as metrorrhagia, intraventricular bleeding, prostatectomies, cataract surgeries and tonsillectomies. The objective of this study was to evaluate the effectiveness of the hemostatic agent ethamsylate to decrease bleeding in total hip replacement surgery. Method: The population were divided into two groups, in the control group was performed the hemostasis conventionally; in the experimental group ethamsylate was administered. Results: A total of 34 patients were included, of whom 17 were randomized to the group of ethamsylate and 17 randomized to the control group. There were no differences in the characteristics of the population between the two groups. Comparing preoperative hemoglobin levels and at 24, 48 and 72 postsurgical hours between the control group and ethamsylate group there was no statistically significant difference. There was also no difference in the levels of hematocrit. In the quantification of expenditure by the drainage there was no difference between the groups at 24 and 48 hours. There were three patients transfused in the ethamsylate group and seven in the control group, which did not differ significantly (p = 0.62). Conclusion: An effect on the reduction of bleeding in patients undergoing total hip replacement with the use of hemostatic agent ethamsylate was not demonstrated in this study.


REFERENCES

  1. Bucholz RW. Indicaciones, técnicas y resultados de reemplazo total de cadera en Estados Unidos. Rev Med Clin Condes. 2014;25:760-4.

  2. Levine BR, Haughom B, Strong B, Hellman M, Frank RM. Blood management strategies for total knee arthroplasty. J Am Acada Orthop Surg. 2014;22:361-71.

  3. Ponnunsamy KE, Thomas TJ, Khnuja HS. Perioperative blood transfusions in orthopaedic surgery. J Bone Joint Surg Am. 2014;96:1836-44.

  4. Raut W, Stone MH, Wroblewski BM. Reduction of postoperative blood loss after press-fit condylar knee arthroplasty with use of a femoral intramedullary plug. J Bone Joint Surg Am. 1993;75:1356-7.

  5. Sáhn DR. Anemia and patient blood management in hip and knee surgery: a systematic review of the literature. Anesthesiology. 2010;113: 482-95.

  6. Bierbaum BE, Callaghan JJ, Galante JO, Rubash HE, Tooms RE, Welch RB. An analysis of blood management in patients having a total hip and knee arthroplasty. J Bone Joint Surg Am. 1999;81:2-10.

  7. Spahn DR. Anemia and patient blood management in hip and knee surgery: a systematic review of the literature. Anesthesiology. 2010;113:482-95.

  8. Goodnough LT, Levy JH, Murphy MF. Concepts of blood transfusion in adults. Lancet. 2013;381:1845-54.

  9. Young SW, Marsh DJ, Akhavani MA, Walker CG, Skinner JA. Attitudes to blood transfusion post arthroplasty surgery in the United Kingdom: a national survey. Int Orthop. 2008;32:325-9.

  10. Wells AW, Mounter PJ, Chapman CE, Stainsby D, Wallis JP. Where does blood go? Prospective observational study of red cell transfusion in north England. BMJ. 2002;325:803

  11. Kirkley SA, Cowles J, Pellegrini VD, Harris CM, Boyd AD, Blumberg N. Blood transfusion and total joint replacement surgery: T helper 2 (TH2) cytokine secretion and clinical outcome. Transfus Med. 1998;8:195-204.

  12. Klein HG. How safe is blood, really? Biologicals. 2010;38:100-4.

  13. Garay RP, Chiavaroli C, Hannaert P. Therapeutic efficacy and mechanism of action of ethamsylate, a long-standing hemostatic agent. Am J Ther. 2006;13:236-47.

  14. Hernández MR, Álvarez-Guerra M, Escolar G, Chiavaroli C, Hannaert P, Garay RP. The hemostatic agent ethamsylate promotes platelet/leukocyte aggregate formation in a model of vascular injury. Fundam Clin Pharmacol. 2004;18:423-30.

  15. Álvarez-Guerra M, Hernández MR, Escolar G, Chiavarolic C, Garaya RP, Hannaer P. The hemostatic agent ethamsylate enhances P-selectin membrane expression in human platelets and cultured endothelial cells. Thromb Res. 2002;107:329-35.

  16. Keith MB. Ethamsylate and blood loss in total hip replacement. Anaesthesia. 1979;34:666-70.




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