title: Reduced Blood Loss and Transfusion Rates: Additional Benefits of Local Infiltration Anaesthesia in Knee Arthroplasty Patients.
abstract: We hypothesised that local infiltration of anaesthesia (LIA) containing adrenaline may reduce peri-operative blood loss and transfusion requirements in primary total knee arthroplasty patients (TKA) when compared to simple patient control analgesia (PCA). In this retrospective cohort study there were 22 TKAs in the PCA group and 27 TKAs in the LIA group. There were no drains used or significant differences in demographics between groups. There was a statistically significant difference in blood loss (P = 0.003), between the LIA group (M = 942 ml, CI 829-1055), and the PCA group (M = 1314 ml, CI 1099-1527). Patients receiving PCA were 4.3 times more likely to require blood transfusion. Using the LIA technique reduces blood loss and risk of blood transfusion.
authors.affiliation: Pennine Acute Hospitals NHS Trust: The Royal Oldham Hospital, Oldham, United Kingdom.
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Bhutta
authors.affiliation: Royal Bolton Hospital NHS Foundation Trust, Lancashire, United Kingdom.
authors.forename: Sanil H
authors.initials: SH
authors.lastname: Ajwani
authors.affiliation: Royal Bolton Hospital NHS Foundation Trust, Lancashire, United Kingdom.
authors.forename: Gordon J
authors.initials: GJ
authors.lastname: Shepard
authors.affiliation: Royal Bolton Hospital NHS Foundation Trust, Lancashire, United Kingdom.
authors.forename: William G
authors.initials: WG
authors.lastname: Ryan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia / Q000379:methods; D016058:Analgesia, Patient-Controlled / Q000706:statistics & numerical data*; D000772:Anesthesia, Local / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D016063:Blood Loss, Surgical / Q000517:prevention & control / Q000706:statistics & numerical data*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D014662:Vasoconstrictor Agents; D004837:Epinephrine
keywords: blood loss; enhanced recovery; knee arthroplasty; local infiltration of anaesthesia; transfusion rates