title: Local infusion of norepinephrine reduces blood losses and need of transfusion in total knee arthroplasty.
abstract: Blood loss after total knee arthroplasty (TKA) is often associated with cardiovascular complications and a high transfusion rate of allogenic blood. In our study we focused our attention on developing a new intra-surgical procedure that appears safe, easy to perform and effective in the reduction of bleeding in TKA. We evaluated 84 patients who underwent TKA and met our inclusion criteria; they were assigned to two groups: 55 controls in which a saline solution was used to wash the surgical field before tourniquet release, and a second group of 29 patients, in which a saline solution containing a low dose of norepinephrine was locally applied before tourniquet release. The local administration of a low dose of norepinephrine has induced a significant reduction of perioperative blood loss and blood transfusion requirements; in addition, this method was characterised by the absence of complications or adverse effects. In conclusion, our data suggest that intraoperative local administration of a low dose of norepinephrine could represent an effective and safe method of reducing blood loss and preventing blood transfusions in patients with TKA.
authors.affiliation: Department of Orthopedics, A Gemelli University Hospital, Università Cattolica del Sacro Cuore School of Medicine, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gasparini
authors.forename: P
authors.initials: P
authors.lastname: Papaleo
authors.forename: P
authors.initials: P
authors.lastname: Pola
authors.forename: S
authors.initials: S
authors.lastname: Cerciello
authors.forename: E
authors.initials: E
authors.lastname: Pola
authors.forename: C
authors.initials: C
authors.lastname: Fabbriciani
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D036502:Infusions, Intralesional; D007430:Intraoperative Care; D008297:Male; D009638:Norepinephrine / Q000008:administration & dosage*; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D016037:Single-Blind Method; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D014662:Vasoconstrictor Agents; D009638:Norepinephrine