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Biomedical subjects

B Borghi

Publications and source records attributed to B Borghi.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Sufentanil vs morphine combined with ropivacaine for thoracic epidural analgesia in major abdominal surgery].

BACKGROUND: Pain, postoperative ileus, nausea, vomiting are the universal complications after major abdominal surgery. The aim of this study was to assess pain relief, side effects and recovery of gastrointestinal function during epidural analgesia with ropivacaine plus sufentanil and ropivacaine plus morphine after major abdominal surgery. METHODS: In this prospective study, sixty patients (median age 62+/-12 years) undergoing major abdominal surgery, after informed consent, were randomized into two groups, during a period of 3 months. Patients who were not considered suitable candidates for epidural anaesthesia were excluded. Epidural catheters were inserted at T8-T9 (upper abdominal surgery) or T9-T11 (lower abdominal surgery) and ropivacaine 0,5% 7-9 ml (upper abdominal surgery) or 10-12 ml (lower abdominal surgery) combined with sufentanil 30 mcg (group S, n=30) or with morphine 2 mg (group M, n=30) was injected. General anaesthesia was induced and a continuous epidural infusion of ropivacaine 0.5% 5-10 ml/h was begun. Postoperatively, continuous epidural administration of ropivacaine 0.2% plus sufentanil 0.5 mcg/ml (group S) or ropivacaine 0.2 plus morphine 0.02 mg/ml (group M) was continued. Data on the quality of analgesia, recovery of gastrointestinal function and all side effects were recorded for 48 hours. RESULTS: Incident and resting pain scores were not significantly different among group; although sufentanil provided better resting pain scores at 16th, 20th, 24th hours, and incident pain score at 24th hour. The incidence of nausea, vomiting and pruritus was more in morphine group (p<0,0001). Time to the first flatus was significantly shorter for patients in the sufentanil group (p<0,0001). The quality of pain relief assessed by the patients was rated as good in all patients. CONCLUSIONS: Continuous administration of epidural ropivacaine combined with sufentanil or with morphine resulted in good analgesia. Epidural analgesia with ropivacaine plus sufentanil provided the best balance of analgesia, side effects and recovery of gastrointestinal function.

Abdomen↗
PubMed2000

Unilateral bupivacaine spinal anesthesia for outpatient knee arthroscopy. Italian Study Group on Unilateral Spinal Anesthesia.

PURPOSE: To compare unilateral and conventional bilateral bupivacaine spinal block in outpatients undergoing knee arthroscopy. METHODS: One hundred healthy, premedicated patients randomly received conventional bilateral (n = 50) or unilateral (n = 50) spinal anesthesia with 8 mg hyperbaric bupivacaine 0.5%. A lateral decubitus position after spinal injection was maintained in unilateral group for 15 min. Times from spinal injection to readiness for surgery, block resolution, and home discharge were recorded. RESULTS: Three patients in each group were excluded due to failed block. Readiness for surgery required 13 min (5 - 25 min) with bilateral and 16 min (15 - 30) with unilateral spinal block (P = 0.0005). Sensory and motor blocks on the operated limb were T9 (T12 - T2) with a Bromage score 0/1/2/3: 0/2/0/45 in the unilateral group and T7 (T12 - T1) with Bromage score 0/1/2/3: 4/1/6/36 with bilateral block(P = 0.026 and P = 0.016, respectively). Vasopressor was required only in five bilateral patients (P = 0.02). Two segment regression of sensory level and home discharge required 81+/-25 min and 281+/-83 min with bilateral block, and 99+/-28 min and 264+/-95 min with unilateral block (P = 0.002 and P = 0.90, respectively). CONCLUSION: Seeking unilateral distribution of spinal anesthesia provided more profound and longer lasting block in the operated limb, less cardiovascular effects, and similar home discharge compared with bilateral spinal anesthesia, with only a slight delay in preparation time.

Adult↗
PubMed2000

Regional anaesthesia for outpatient knee arthroscopy: a randomized clinical comparison of two different anaesthetic techniques.

BACKGROUND: The purpose of this prospective, randomized study was to evaluate the time required to perform anaesthesia, achieve surgical block and fulfil standardized discharge criteria in outpatients receiving knee arthroscopy with either spinal anaesthesia or combined sciatic-femoral nerve block. METHODS: After a standard midazolam/ketoprofen premedication and baseline measurement of cardiovascular parameters, 50 ASA I-II patients scheduled for elective outpatient knee arthroscopy were randomized to receive spinal anaesthesia with 8 mg of 0.5% hyperbaric bupivacaine (group Spinal, n=25), or combined sciatic-femoral nerve block with 25 ml of mepivacaine 20 mg ml(-1) and a multiple injection technique (15 ml for femoral nerve block and 10 ml for sciatic nerve block). Times lasting from skin disinfection to the end of local anaesthetic injection (preparation time) and then to achieve surgical anaesthesia (readiness for surgery), as well as times required for block resolution, micturition, unassisted ambulation, and home discharge were recorded by a blinded observer. Occurrence of adverse events was also recorded. RESULTS: Preparation time (mean+/-SD) was longer with sciatic-femoral block (8+/-2.7 min) than spinal anaesthesia (5+/-2.1 min) (P=0.0002) while no differences were observed in the time required to achieve readiness for surgery (14+/-5 min and 15+/-6 min in the Spinal and Sciatic-femoral groups, respectively). No differences in haemodynamic side effects and need for intraoperative additional analgesia were observed. Patients receiving spinal anaesthesia showed a faster resolution of nerve block and longer time to micturition (137+/-49 min and 231+/-101 min) than patients receiving peripheral nerve blockade (206+/-51 min and 145+/-36 min) (P<0.0005 and P=0.002, respectively); however, no differences were observed in the time required to fulfil standardized discharge criteria (241+/-101 min in group Spinal and 209+/-70 min in group Sciatic-femoral; P=0.86). CONCLUSION: In patients receiving elective outpatient knee arthroscopy, using a combined sciatic-femoral nerve block with 25 ml of mepivacaine 20 mg ml(-1) and a multiple injection technique results in a slightly longer preoperative time but provides similarly effective anaesthesia with no differences in home discharge times as compared to spinal anaesthesia with 8 mg hyperbaric bupivacaine.

Adult↗
PubMed2000

Combined sciatic-femoral nerve block with 0.75% ropivacaine: effects of adding a systemically inactive dose of fentanyl.

To evaluate the effects of adding low-dose fentanyl to 0.75% ropivacaine during peripheral nerve blocks, 30 ASA physical status I-II patients undergoing hallux valgus repair under combined sciatic-femoral nerve block were randomly allocated in a double-blind fashion to receive nerve block placement with 30 mL of either 0.75% ropivacaine alone (group: ropivacaine, n = 15) or 0.75% ropivacaine plus fentanyl 1 microg kg(-1) (group: ropivacaine-fentanyl, n = 15). A blinded observer recorded haemodynamic variables and sedation, as well as the time required to achieve surgical block and the first request for analgesia. Readiness to surgery required 10 min (5-20 min) with 0.75% ropivacaine and 10 min (3-20 min) with the ropivacaine-fentanyl mixture. No differences in the degree of sedation, peripheral oxygen saturation, and haemodynamic variables were observed between the two groups. The degree of pain measured at first analgesic request, and the consumption of postoperative analgesics, was similar in the two groups, while the mean time from block placement to the first request for pain medication was 13.7 h (25-75th percentiles: 11.8-14.5 h) in the ropivacaine group and 13.9 h (25-75th percentiles: 10.5-14.5 h) in the ropivacaine-fentanyl group (P = not significant). We conclude that adding fentanyl 1 microg kg(-1) to 0.75% ropivacaine did not provide clinically relevant advantages in terms of onset time, quality and duration of combined sciatic-femoral nerve block in patients undergoing elective hallux valgus repair.

Adjuvants, Anesthesia↗
PubMed2000

Incidence and risk factors for allogenic blood transfusion during major joint replacement using an integrated autotransfusion regimen. The Rizzoli Study Group on Orthopaedic Anaesthesia.

The efficacy of an integrated autotransfusion regimen, including pre-donation and perioperative salvage of autologous blood, was prospectively evaluated in 2884 patients undergoing total hip (n = 2016) or knee arthroplasty (n = 480), and hip revision (n = 388) with either balanced general, regional, or integrated epidural/general anaesthesia. Allogenic concentrated red blood cells were transfused in the presence of symptomatic anaemia or when haemoglobin concentration was < 6 g dL-1 (10 g dL-1 in patients affected by cerebrovascular or coronary artery disease) after all salvaged and pre-donated autologous blood had been transfused. A total of 278 patients (9.6%) received allogenic blood. Risk factors for allogenic blood transfusion were: preoperative haemoglobin concentration < 10 g dL-1 (after autologous blood pre-donations) (Odds ratio: 8.7; 95% CI: 6.5-16.8; P = 0.004), hip revision versus hip or knee arthroplasty (Odds ratio: 5.8; 95% CI: 3.9-8.5; P = 0. 0001) and inability in obtaining the number of pre-donations required by the Maximum Surgery Blood Order on Schedule (Odds ratio: 3.4; 95% CI: 2.7-4.1; P = 0.0001). The incidence of perioperative complications, including wound infection and haematoma, as well as myocardial ischaemia, respiratory failure and thromboembolic complications, was higher in those patients requiring allogenic blood transfusion (29.8%) than that observed in patients receiving only autologous blood (6.6%) (P = 0.0005); while the mean time duration from surgical procedure to patient discharge from the orthopaedic ward was shorter in those patients not receiving allogenic blood transfusion (12 days; 25-75th percentiles: 8-14 days) than in those patients who required perioperative transfusion with allogenic blood (15 days; 25-75th percentiles: 10-17 days) (P = 0.0005). In conclusion, this prospective study highlighted the clinical relevance of applying an extensive and integrated autotransfusion regimen in order to reduce allogenic blood transfusion and associated complications in patients undergoing major joint replacement.

Aged↗
PubMed2000

Accuracy of end-tidal carbon dioxide monitoring using the NBP-75 microstream capnometer. A study in intubated ventilated and spontaneously breathing nonintubated patients.

Arterial carbon dioxide partial pressure measurements using the NBP-75 microstream capnometer were compared with direct PaCO2 values in patients who were (a) not intubated and spontaneously breathing, and (b) patients receiving intermittent positive pressure ventilation of the lungs and endotracheal anaesthesia. Twenty ASA physical status I-III patients, undergoing general anaesthesia for orthopaedic or vascular surgery were included in a prospective crossover study. After a 20-min equilibration period following the induction of general anaesthesia, arterial blood was drawn from an indwelling radial catheter, while the end-tidal carbon dioxide partial pressure was measured at the angle between the tracheal tube and the ventilation circuit using a microstream capnometer (NBP-75, Nellcor Puritan Bennett, Plesanton, CA, USA) with an aspiration flow rate of 30 mL min(-1). Patients were extubated at the end of surgery and transferred to the postanaesthesia care unit, where end-tidal carbon dioxide was sampled through a nasal cannula (Nasal FilterLine, Nellcor, Plesanton, CA, USA) and measured using the same microstream capnometer. In each patient six measurements were performed, three during mechanical ventilation and three during spontaneous breathing. A good correlation between arterial and end-tidal carbon dioxide partial pressure was observed both during mechanical ventilation (r = 0.59; P = 0.0005) and spontaneous breathing (r = 0.41; P = 0.001); while no differences in the arterial to end-tidal carbon dioxide tension difference were observed when patients were intubated and mechanically ventilated (7. 3 +/- 4 mmHg; CI95: 6.3-8.4) compared to values measured during spontaneous breathing in the postanesthesia care unit, after patients had been awakened and extubated (6.5 +/- 4.8 mmHg; CI95: 5. 2-7.8) (P = 0.311). The mean difference between the arterial to end-tidal carbon dioxide tension gradient measured in intubated and non-intubated spontaneously breathing patients was 1 +/- 6 mmHg (CI95: -11-+13). We conclude that measuring the end-tidal carbon dioxide partial pressure through a nasal cannula using the NBP-75 microstream capnometer provides an estimation of arterial carbon dioxide partial pressure similar to that provided when the same patients are intubated and mechanically ventilated.

Aged↗
PubMed2000

Unilateral spinal anesthesia or combined sciatic-femoral nerve block for day-case knee arthroscopy. A prospective, randomized comparison.

BACKGROUND: To evaluate the time required to achieve surgical block and fulfill standardized discharge criteria in outpatients receiving knee arthroscopy with either unilateral spinal anesthesia or combined sciatic-femoral nerve block. METHODS: After a standard midazolam/ketoprofen premedication and baseline measurement of cardiovascular parameters, 50 ASA physical status I-II patients scheduled for elective outpatient knee arthroscopy were randomized to receive unilateral spinal anesthesia with 8 mg of 0.5% hyperbaric bupivacaine injected without barbotage through a 25-gauge Whitacre spinal needle (group USA, n = 25), or combined sciatic-femoral nerve block with 25 ml of 2% mepivacaine (15 ml for femoral nerve block and 10 ml for sciatic nerve block) (group SFNB, n = 25). Times from local anesthetic injection to achievement of surgical block defined as the presence of adequate motor (complete motor blockade of the operated limb in the USA group and inability to move the ankle and the knee of the operated limb in the SFNB group) and sensory (loss of pinprick sensation at T12 on the operated side in the USA group, or in the femoral and sciatic nerves distribution in the SFNB group) blocks was recorded. Times to block resolution, urination, unassisted ambulation, and readiness to home discharge were also recorded by a blind observer, as well as occurrence of untoward events during surgery. RESULTS: Surgical block was achieved in 15 +/- 6 min in group USA and 16 +/- 6 min in group SFNB (p = NS). No differences in hemodynamic undesired effects and success rate were observed. Even though USA patients showed a faster time to ambulation (166 +/- 44 min versus 217 +/- 49 min, p = 0.002) and later urination (240 +/- 90 min versus 145 +/- 36 min, p = 0.0001) than SFNB group, no differences in home discharging were reported (246 +/- 98 min versus 211 +/- 77 min, respectively). Bladder catheterization was required in 2 patients of USA group only; however, no patient was admitted to the hospital because of urinary retention. CONCLUSIONS: In outpatient knee arthroscopy, a combined sciatic-femoral nerve block with 2% mepivacaine provides similarly successful anesthesia with onset times and home discharge similar to those provided by unilateral spinal anesthesia.

Adolescent↗
PubMed1999

A clinical comparison of ropivacaine 0.75%, ropivacaine 1% or bupivacaine 0.5% for interscalene brachial plexus anaesthesia.

In order to compare interscalene brachial plexus block performed with ropivacaine or bupivacaine, 45 healthy, unpremedicated patients, undergoing elective shoulder surgery, were randomly allocated to receive interscalene brachial plexus anaesthesia with 20 mL of either ropivacaine 0.75% (n = 15), ropivacaine 1% (n = 15), or bupivacaine 0.5% (n = 15). Readiness for surgery (loss of pinprick sensation from C4 to C7 and inability to elevate the limb from the bed) was achieved later with bupivacaine 0.5% (28 +/- 15 min) than with ropivacaine 1% (10 +/- 5 min) (P = 0.005) and ropivacaine 0.75% (15 +/- 8 min) (P = 0.0005). No differences in success rate were observed between the three groups; however, seven patients receiving bupivacaine 0.5% required intra-operative analgesic supplementation (fentanyl 0.1 mg intravenous) compared with one patient receiving ropivacaine 0.75%, and two patients treated with ropivacaine 1% (P = 0.02). The time from the block placement to first request for pain medication was similar in the three groups (10.7 +/- 2 h, 11 +/- 2.4 h, and 10.9 +/- 3.9 h after 0.75% and 1% ropivacaine or 0.5% bupivacaine, respectively). We conclude that interscalene brachial plexus block performed with 20 mL of either 0.75% or 1% ropivacaine allows for a prolonged post-operative pain relief, similar to that provided by bupivacaine 0.5%, with short onset time of surgical anaesthesia.

Adolescent↗
PubMed1999

Ropivacaine or 2% mepivacaine for lower limb peripheral nerve blocks. Study Group on Orthopedic Anesthesia of the Italian Society of Anesthesia, Analgesia, and Intensive Care.

BACKGROUND: Intra- and postoperative clinical properties of sciatic-femoral nerve block performed with either ropivacaine at different concentrations or mepivacaine have been evaluated in a multicenter, randomized, blinded study. METHODS: Adult patients scheduled for foot and ankle surgery were randomized to receive combined sciatic-femoral nerve block with 225 mg of either 0.5% (n = 83), 0.75% (n = 87), or 1% (n = 86) ropivacaine, or with 500 mg of 2% mepivacaine (n = 84). A thigh tourniquet was used in all patients. Onset time, adequacy of surgical anesthesia, time to offset of nerve block, and time until first postoperative requirement for pain medication were evaluated by a blinded observer. RESULTS: The adequacy of nerve block was similar in the four treatment groups (the ratios between adequate:inadequate: failed blocks were 74:9:0 with 0.5% ropivacaine, 74:13:0 with 0.75% ropivacaine, 78:8:0 with 1% ropivacaine, and 72:12:0 with 2% mepivacaine). The onset of the block was slower with 0.5% ropivacaine than with other anesthetic solutions (P < 0.001). Regardless of the concentration, ropivacaine produced a longer motor blockade (10.5+/-3.8 h, 10.3+/-4.3 h, and 10.2+/-5.1 h with 0.5%, 0.75%, and 1% ropivacaine, respectively) than with mepivacaine (4.3+/-2.6 h; P < 0.001). The duration of postoperative analgesia was shorter after mepivacaine (5.1+/-2.7 h) than after ropivacaine (12.2+/-4.1 h, 14.3+/-5 h, and 14.5+/-3.4 h, with 0.5%, 0.75%, or 1% ropivacaine, respectively; P < 0.001). Pain relief after 0.5% ropivacaine was 14% shorter than 0.75% or 1% ropivacaine (P < 0.05). During the first 24 h after surgery, 30-37% of patients receiving ropivacaine required no analgesics compared with 10% of those receiving mepivacaine (P < 0.001). CONCLUSIONS: This study suggests that 0.75% ropivacaine is the most suitable choice of local anesthetic for combined sciatic-femoral nerve block, providing an onset similar to mepivacaine and prolonged postoperative analgesia.

Adult↗
PubMed1999

Reducing perioperative blood loss in patients undergoing total hip arthroplasty.

In this prospective, randomised, double-blind study, we investigated the effect of epidural anaesthesia and an antifibrinolytic agent, Aprotinin (500,000 KIU in bolus before surgery and 500,000 KIU h(-1) in drip form during surgery), on intra and postoperative blood loss and transfusion requirements in total hip arthroplasty. Sixty patients were allocated randomly to four groups (A: epidural + general anesthesia + Aprotinin, B: epidural + general anesthesia + placebo (equal volume), C: general anaesthesia + Aprotinin, D: general anaesthesia + placebo). Postoperative analgesia: epidural analgesia in groups A and B, systemic analgesia with opiates in groups C and D. Blood loss during surgery was monitored and salvaged with the Compact-A Dideco, and postoperative blood loss with the BT 797 Recovery Dideco for the first 24 hours. Perioperative blood loss, frequency and quantity of transfusions were significantly higher in group D (p<0.0001). Total blood loss was reduced by 31.3% by epidural anaesthesia, 20.4% by Aprotinin and 51.4% using a combination of the two techniques.

Aged↗
PubMed1999

Autotransfusion with predeposit-haemodilution and perioperative blood salvage: 20 years of experience. Rizzoli Study Group on Orthopaedic Anesthesia.

BACKGROUND: Through a prospective study, we evaluated the efficacy of an integrated autotransfusion regimen comprised of predeposit-hemodiluition and intra and post-operative blood salvage in major orthopaedic surgery. METHODS: We examined the records of 2303 consecutive patients (1524 females and 779 males, mean age 62.7, standard deviation 11 years (range 16-90 yrs), pre-operative haemoglobin (Hb) concentration 13.5 (SD 1.4) (range 6.7-19.3) g/dl undergong total hip arthroplasty (THA 1582 patients), THA after the removal of internal fixation devices (RFD+THA, 25 patients), total knee arthroplasty (TKA, 347 patients), revision surgery of the hip (HR, cup+stem revision, 248 patients; cup revision 64 patients; stem revision 23 patients) and total knee revision (TKR 14 patients). We estimated that the number of predonations (MSBOS - maximum surgery blood order schedule) was 2 units for THA, TKA and TKR, and 3 units for partial or total hip revision and for total hip arthroplasty with fixation removal. RESULTS: It was possible to obtain the MSBOS in 2070 patients (89.8%). Homologous red blood cell (HRBC) transfusion were carried out in 184 patients (8%). We found that the need to use HRBC was significantly associated with failure to meet the number of MSBOS, female sex, lower pre-operative Hb concentration, use of calcium heparin for antithrombosis prophylaxis, more extensive surgery, a higher ASA rating and co-existing diseases such as coronary artery disease. CONCLUSIONS: Cooperation among anaesthesis, transfusionists and surgeons in the application of an integrated autotransfusion regimen enabled us to treat 92% of our patients with only autotransfusion.

Adolescent↗
PubMed1999

Effects of predeposit and intentional perioperative haemodilution on blood saving program in major orthopaedic surgery.

In this study we evaluated the effects of predeposit and intentional perioperative haemodilution on a blood saving program in major orthopaedic surgery. We demonstrated that autologous blood phlebotomy and maintenance of optimal levels of perioperative haemodilution by delaying blood transfusion, even autologous, are efficient techniques in reducing homologous, red blood cell (HRBC) transfusion. Patients who received autologous red blood cell (ARBC) or HRBC more than one day after surgery, while having Hb values <8 g/dl, are less at risk of needing the first or additional HRBCs. In conclusion, predeposit and intentional haemodilution obtained by delaying blood transfusions, even autotransfusional, is a correct way of conducting a blood saving program (BSP) in major orthopaedic surgery. These techniques are clinically effective in avoiding or reducing HRBC transfusion.

Aged↗
PubMed1998

Low dose hyperbaric bupivacaine for unilateral spinal anaesthesia.

PURPOSE: To evaluate the effects of hyperbaric bupivacaine concentration in producing unilateral spinal anaesthesia. METHODS: With Ethical Committee approval and written consent, 60 patients undergoing lower limb surgery were placed in the lateral position with the side to be operated on dependent. After dural puncture (25-gauge Whitacre spinal needle), the needle hole was turned toward the dependent side and patients were randomly assigned to receive 8 mg of either 0.5% (Group0.5%, n = 30) or 1% (Group1%, n = 30) hyperbaric bupivacaine. The lateral position was maintained for 15 min, while a blinded observer recorded loss of pinprick sensation and degree of motor block on both sides until two segment regression of sensory level on the dependent side. RESULTS: At the end of the 15 min lateral position spinal anaesthesia was more frequently unilateral in Group0.5% (80%) than in Group1% (53%)(P < 0.05). However, 30 min after patients were turned supine, unilateral spinal anaesthesia decreased to 60% of cases in Group0.5% and 40% of cases in Group1% (P = NS). The maximum sensory level on the dependent side [T10(L1-T2) in Group0.5% and T8 (T12-T3) in Group1%], time to reach it [20 (5-30) min in Group0.5% and 25 (10-35) min in Group1%], and time to two segment regression of sensory level [80 (30-135) min in Group0.5% and 75 (20-135) min in Group1%] were similar in both groups. CONCLUSION: Highly concentrated solutions of hyperbaric bupivacaine are not advantageous in obtaining a unilateral spinal anaesthesia, when a small anaesthetic dose is injected slowly through a Whitacre spinal needle.

Adult↗
PubMed1998

Blood salvage during caesarean section.

The aim of this study was to assess blood salvage during Caesarean section. In 15 Caesarean sections, red cells lost were collected and washed with a Dideco machine and tested for the presence of fetoplacental material, bacterial contamination, free haemoglobin and fetal blood cells. Successive patients were allocated randomly to one of two groups. In group 1 (n = 34), intraoperative blood was salvaged, while group 2 served as a control. The mean amount of blood salvaged in group 1 was 363 (SD 153) ml. Blood was salvaged following these guidelines: identification of blood group of the mother and fetus; avoidance of aspirating blood from the umbilical cord; commencement of salvage after removing the fetoplacental unit; completely filling the centrifugation bowl with red cells; washing the cells using at least 1000 ml of physiological solution per bowl; and mixing the contents of the bowl, completely eliminating the buffy coat where fetal cells are located. In group 1, the use of homologous blood transfusions was significantly lower (one of 34 (2.9%) patients compared with eight of 34 (23.5%); P = 0.01), haemoglobin concentrations during the first 4 days after operation were significantly higher and postoperative hospital stay was significantly shorter. Duration of hospital stay was significantly shorter in group 1 (5.3 (1.9) vs 7.3 (4) days; P = 0.003). Mean base haemoglobin concentrations were significantly lower in group 1 (10.7 (1.4) vs 11.7 (1.5) g dl-1; P > 0.0001), while after surgery mean haemoglobin concentrations were significantly higher approximately 3 h after operation compared with the control group (10.2 (1.5) vs 8.6 (1.2) g dl-1; P < 0.0001). On the first day, haemoglobin concentrations were 9.8 (1.5) vs 8 (1.4) g dl-1 (P < 0.0001), on the second day 9.8 (1.4) vs 7.7 (1.4) g dl-1 (P < 0.0001), on the third day 10.1 (1.5) vs 7.5 (1.3) g dl-1 (P < 0.0001) and on the fourth day 10.4 (1.5) vs 8.1 (1.4) g dl-1 (P < 0.0001).

Adolescent↗
PubMed1998

Intensive predeposit-hemodilution autologous blood donation and IOBS increase in erythropoietic levels in patients undergoing hip arthroplasty.

Erythropoietin (EPO) plasma levels were monitored during the perioperative period in 61 consecutive patients (22 males - 39 females), aged 62.5 +/- 9.5 years, scheduled for hip arthroplasty. All patients underwent intraoperative blood salvage (IOBS) and were subdivided into three different groups according to their hemoglobin levels (Hb) 24 hours postoperatively (group A: Hb < 8 g/dl; group B: Hb between 8-9 g/dl; group C: HB > or = 9 g/dl). Seventy-two hours after surgery EPO levels were significantly different in group A (135 +/- 68) compared to group C (54.3 +/- 32), with a positive correlation (p < 0.01) between Hb and EPO levels. On the basis of these results we suggest that a programmed autologous red blood cell collection aimed at obtaining the lowest hemoglobin values during the first 24 hours after surgery, may be of clinical utility in preventing homologous blood needs.

Aged↗