THE HEMOSTATIC EFFECTS OF DESMOPRESSIN ON PATIENTS WHO HAD TOTAL JOINT ARTHROPLASTY - A DOUBLE-BLIND RANDOMIZED TRIAL

The effects of desmopressin on postoperative bleeding and postoperativ e transfusion requirements were studied in ninety-two hemostatically n ormal patients who had had an elective primary total hip or total knee arthroplasty. The patients were randomized into either a placebo or a desmopressin group in a double-blind prospective clinical trial. Duri ng closure of the wound, desmopressin (0.03 microgram per kilogram of body mass) or the placebo was infused into a peripheral vein over a tw enty-minute period. Compared with the placebo, desmopressin did not si gnificantly decrease blood loss or transfusion requirements, and it di d not affect the postoperative platelet or fibrinogen levels or the bl eeding time. The results were no different even when the treatment and control groups mere matched according to surgeon, use of cement for t he femoral and knee components, preoperative use of non-steroidal anti -inflammatory agents, or performance of a lateral release for total kn ee arthroplasty. We concluded that desmopressin does not reduce blood loss or transfusion requirements after total joint arthroplasty.