DO LOW-MOLECULAR-WEIGHT HEPARIN AND DEXTRAN INCREASE THE BLOOD-LOSS IN TRANSURETHRAL RESECTION OF THE PROSTATE

Objective To evaluate whether the use of dextran or the combination of low molecular weight heparin and dextran increases the blood loss in elective transurethral resection for benign prostatic hyperplasia. Pat ients and methods This open randomized controlled study included 198 p atients operated under spinal anaesthesia who were allocated to four g roups differing in the combination of prophylactic treatment used for thrombosis and for the substitution of blood loss. The prophylactic tr eatment was either dalteparin sodium, continued each day until mobiliz ation, or 3% Ringer dextran-60 just before operation and continued wit h 6% dextran-70 for 2 days post-operatively, and the volume substitute was Ringer dextran or Ringer's acetate. Thus, the four treatments (by prophylaxis and volume substitute, respectively) were dalteparin and Ringer's acetate, dalteparin and dextran, dextran and Ringer's acetate , and dextran and dextran. The haemoglobin lost to the irrigation flui d was measured and used to calculate blood loss. Results Patients rece iving dextran had a larger postoperative and total blood loss than tho se who did not. The need for transfusion did not differ between the tr eatment groups. Conclusion The combination of dalteparin and dextran w as not associated with an increased blood loss above that with dextran alone.