THE EFFICACY OF SINGLE-DOSE APROTININ 2 MILLION KIU IN REDUCING BLOOD-LOSS AND ITS IMPACT ON THE INCIDENCE OF DEEP VENOUS THROMBOSIS IN PATIENTS UNDERGOING TOTAL HIP-REPLACEMENT SURGERY

Study Objective: To evaluate the efficacy of a 2 million KIU single do se of aprotinin on blood loss, transfusion requirements, and incidence of deep venous thrombosis (DVT) in patients undergoing total hip repl acement surgery Design: Randomized study Setting: Operating theater at an orthopedic hospital Patients: 40 adult patients scheduled for tota l hip replacement surgery Interventions: Patients were randomized to t wo groups. Group A (n = 20) received 2 million KIU of aprotinin over 2 0 minutes, Group C (n = 20), the control group, received placebo. Anes thesia and surgical technique were standardized. Measurements and Main Results: Intraoperative blood loss, postoperative blood loss, transfu sion requirements (48 hr), hemoglobin, coagulation parameters, and pla telet counts were assessed. On the seventh postoperative day, all pati ents in both groups underwent venography to ascertain the incidence of DVT. We found no significant difference in blood loss or transfusion requirements between the two groups. Intraoperative and postoperative blood losses, coagulation parameters, and incidence of DVT did not dif fer significantly between the two groups. Conclusion: A single 2 milli on KIU bolus dose of aprotinin does not reduce perioperative blood los s or transfusion requirements. Aprotinin therapy, when used in conjunc tion with other antithrombotic therapies, does not increase the incide nce of DVT after major orthopedic surgery.