title: Blood-sparing efficiency of transdermal nitroglycerine during open fixation of femur shaft fractures: a randomized, double-blind study.
abstract: OBJECTIVE
  To evaluate the effect of transdermal nitroglycerine for reducing blood loss during open fixation of femur shaft fractures.
  
  
  METHODS
  Randomized, double blind, clinical trial.
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  60 ASA physical status I and II patients undergoing elective open fixation of femur shaft fractures.
  
  
  METHODS
  Patients were randomized to two groups: those who received 3-in (7.5 cm) transdermal nitroglycerine (group N) or 3-in (7.5 cm) placebo (group P). All the drugs used for induction and maintenance of anesthesia were similar in both groups and administered according to the patient's weight.
  
  
  METHODS
  In both groups, baseline heart rate and blood pressure were recorded and then measured every 5 minutes thereafter. Routine estimation, as well as a mathematical model of blood loss calculation, was used to determine intraoperative blood loss.
  
  
  RESULTS
  Group N had a significant lower systolic, diastolic, and mean arterial blood pressure than those of group P during the operation. The mean estimated blood loss in group N (443.4 +/- 158.0 mL) was significantly lower than that in group P (950.0 +/- 554.9 mL). The calculated blood loss (622.7 +/- 192.4 mL) in group N was also significantly lower than that in group P (1232.1 +/- 630.4 mL).
  
  
  CONCLUSIONS
  By inducing moderate hypotension, the use of transdermal nitroglycerine decreases intraoperative blood loss and the need for transfusion.
authors.affiliation: Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Asif Perviz
authors.initials: AP
authors.lastname: Kazemi
authors.forename: Farid
authors.initials: F
authors.lastname: Zand
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Sedaghat
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000494:pharmacology*; D014665:Vasodilator Agents / Q000494:pharmacology*
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin