Local infusion of norepinephrine reduces blood losses and need of transfusion in total knee arthroplasty

• Published in: International orthopaedics Vol. 30; no. 4; pp. 253 - 256
• Main Authors: Gasparini, G, Papaleo, P, Pola, P, Cerciello, S, Pola, E, Fabbriciani, C
• Format: Journal Article
• Language: English
• Published: Germany Springer-Verlag 01.08.2006
• Subjects: Aged; Arthroplasty, Replacement, Knee; Blood Loss, Surgical - prevention & control; Blood Transfusion - statistics & numerical data; Female; Humans; Infusions, Intralesional; Intraoperative Care; Male; Norepinephrine - administration & dosage; Original Paper; Postoperative Hemorrhage - prevention & control; Single-Blind Method; Vasoconstrictor Agents - administration & dosage
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-005-0050-2

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.