Aprotinin reduces blood loss and the need for transfusion in orthognathic surgery.
A randomized, placebo-controlled, double-blind trial (n= 15 in each group) showed that patients given aprotinin intravenously (200 ml, [2000000 kallikrein inactivator units] before the operation and then 50 ml per h until the end of the operation) during simultaneous maxillary Le Fort 1 and mandibular sagittal split osteotomies, lost 52% less blood than controls (calculated by subtracting the volume of saline irrigant used from the volume of blood collected in the aspirator bottle and surgical drains). Patients given aprotinin lost a mean (SD) of 473 (190) ml compared with 986 (356) ml in controls. They also required significantly less transfused blood (1 was given 2 units in the aprotinin group compared with 9 given a mean of 1.5 units (range 1-4) in the control group). There were no complications attributable to this drug.
Stewart
A
A
Maxillofacial Unit, Queen Mary's Hospital, London, UK.
Newman
L
L
Sneddon
K
K
Harris
M
M
D000328:Adult; D007611:Aprotinin / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D004311:Double-Blind Method; D004322:Drainage; D005440:Fluid Therapy; D005500:Follow-Up Studies; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006490:Hemostatics / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D008334:Mandible / Q000601:surgery*; D008437:Maxilla / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D019340:Osteotomy, Le Fort / Q000379:methods; D010919:Placebos; D010976:Platelet Count; D011292:Premedication; D012965:Sodium Chloride; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D013396:Suction; D007507:Therapeutic Irrigation
D006454:Hemoglobins; D006490:Hemostatics; D010919:Placebos; D012965:Sodium Chloride; D007611:Aprotinin