The efficacy of single-dose aprotinin 2 million KIU in reducing blood loss and its impact on the incidence of deep venous thrombosis in patients undergoing total hip replacement surgery.
OBJECTIVE
To evaluate the efficacy of a 2 million KIU single dose of aprotinin on blood loss, transfusion requirements, and incidence of deep venous thrombosis (DVT) in patients undergoing total hip replacement surgery.


METHODS
Randomized study.


METHODS
Operating theater at an orthopedic hospital.


METHODS
40 adult patients scheduled for total hip replacement surgery.


METHODS
Patients were randomized to two groups. Group A (n = 20) received 2 million KIU of aprotinin over 20 minutes, Group C (n = 20), the control group, received placebo. Anesthesia and surgical technique were standardized. MEASUREMENTS AND MAIN-RESULTS: Intraoperative blood loss, postoperative blood loss, transfusion requirements (48 hr), hemoglobin, coagulation parameters, and platelet counts were assessed. On the seventh postoperative day, all patients in both groups underwent venography to ascertain the incidence of DVT. We found no significant difference in blood loss or transfusion requirements between the two groups. Intraoperative and postoperative blood losses, coagulation parameters, and incidence of DVT did not differ significantly between the two groups.


CONCLUSIONS
A single 2 million KIU bolus dose of aprotinin does not reduce perioperative blood loss or transfusion requirements. Aprotinin therapy, when used in conjunction with other antithrombotic therapies, does not increase the incidence of DVT after major orthopedic surgery.
Hayes
A
A
Department of Anaesthesia, Cappagh Hospital, Finglas, Dublin, Ireland.
Murphy
D B
DB
McCarroll
M
M
D000328:Adult; D000368:Aged; D007611:Aprotinin / Q000008:administration & dosage / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis; D006490:Hemostatics / Q000008:administration & dosage / Q000627:therapeutic use*; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D007431:Intraoperative Complications; D008297:Male; D010690:Phlebography; D010919:Placebos; D010976:Platelet Count / Q000187:drug effects; D011183:Postoperative Complications; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000209:etiology*
D005343:Fibrinolytic Agents; D006454:Hemoglobins; D006490:Hemostatics; D010919:Placebos; D007611:Aprotinin