The effect of epsilon aminocaproic acid on blood loss in patients who undergo primary total hip replacement: a pilot study.
OBJECTIVE
To determine if the use of an antifibrinolytic agent (epsilon aminocaproic acid [EACA]) decreased perioperative and postoperative blood loss in patients who underwent total hip arthroplasty (THA).


METHODS
A prospective, double-blind, randomized, controlled clinical trial.


METHODS
A university-affiliated tertiary care hospital with a large joint arthroplasty population.


METHODS
Fifty-five patients who were scheduled for a primary THA.


METHODS
Patients were randomly assigned to 2 groups to receive either EACA or saline placebo perioperatively. Preoperatively, the groups were similar with respect to gender, mean age, mean hemoglobin level, operative time and prosthesis type.


METHODS
Blood loss from the start of surgery until the Hemovac drain was removed, and the transfusion rate and hemoglobin levels.


RESULTS
Mean (and standard error) total blood loss for patients receiving EACA was 867 (207) mL and for patients receiving placebo was 1198 (544) mL (p < 0.025). Four patients in the EACA group received 7 units of packed red blood cells and 7 patients in the saline group required 12 units.


CONCLUSIONS
Patients receiving the placebo sustained greater total blood loss than EACA patients and were more likely to require blood transfusion. In the current climate of concern over blood transfusions during surgery, EACA administration can reduce blood loss and consequently transfusion and transfusion-related risk.
Harley
Brian J
BJ
Division of Orthopaedic Surgery, University of Alberta Hospital, Edmonton.
Beaupré
Lauren A
LA
Jones
C Allyson
CA
Cinats
John G
JG
Guenther
Craig R
CR
D000368:Aged; D015119:Aminocaproic Acid / Q000627:therapeutic use*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies
D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D015119:Aminocaproic Acid