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KMID : 1155520080030030178
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Anesthesia and Pain Medicine
2008 Volume.3 No. 3 p.178 ~ p.182
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The Effect of Low Dose Aprotinin in Patients with Adolescent Idiopathic Scoliosis Undergoing Posterior Spinal Fusion
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Park Hae-Gyun
Yoo Byung-Hoon
Lee Sang-Seok
Yon Jun-Heum
Hong Ki-Hyuk
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Abstract
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Background: Aprotinin is a kallikrein inhibitor at high doses and a plasmin inhibitor at low doses. Low-dose aprotinin has been shown to reduce transfusion requirements in patients undergoing liver resection, open-heart surgery, and spine deformity surgery. The aim of this study was to evaluate the effect of low-dose aprotinin on perioperative blood loss and on transfusion requirements in adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion.
Methods: We studied forty patients who were set to undergo posterior spinal fusion. Twenty patients were given aprotinin, and twenty control patients were not given aprotinin. Patients were assessed for pre- and post-operative hemoglobin, hematocrit, platelet count, blood urea nitrogen, and creatinine. Perioperative blood loss was measured through suction drains and gauze, and transfusion requirements were recorded.
Results: Upon comparing the aprotinin and control groups, we found no differences in intraoperative blood loss (1,456 +/- 622 ml vs 1,625 +/- 738 ml, respectively, [P = 0.17]), total (intraoperative and 24 h postoperative) blood loss (2,544 +/- 977 ml vs 2,594 +/- 783 ml, respectively, [P = 0.42]), or homologous transfusion requirements (1,672 +/- 1,077 ml vs 1,520 +/- 718 ml packed RBCs, respectively, [P = 0.52]). Renal function was maintained in both groups.
Conslusions: Low-dose aprotinin does not decrease blood loss or transfusion requirements in AIS patients undergoing posterior spinal fusion. Renal function was maintained in both the aprotinin and control groups.
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KEYWORD
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aprotinin, adolescent idiopathic scoliosis, posterior spinal fusion
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