Reactionary haemorrhage reduction with adrenaline infiltration in proximal tibial osteotomy: a randomized clinical study of safety and efficacy

Introduction In corrective osteotomy, wound closure is undertaken with or without deflation of the tourniquet. Hypoxia from the tourniquet causes vasodilatation associated with reactionary haemorrhage and reduced haemoglobin concentration and possibly increased blood transfusion rate. Reactionary ha...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2012, Vol.132 (1), p.21-24
Main Authors: Ogbemudia, Alfred O., Bafor, Anire, West-Osemwengie, Loius
Format: Article
Language:English
Subjects:
Administration, Topical
Adolescent
Blood Transfusion - statistics & numerical data
Blood transfusions
Child
Child, Preschool
Double-Blind Method
Epinephrine - therapeutic use
Erythrocyte Indices
Female
Genu Varum - surgery
Hemoglobin
Hemostasis, Surgical - methods
Humans
Male
Medicine
Medicine & Public Health
Orthopaedic Surgery
Orthopedics
Osteotomy
Postoperative Hemorrhage - blood
Postoperative Hemorrhage - etiology
Postoperative Hemorrhage - prevention & control
Postoperative Hemorrhage - therapy
Sodium Chloride
Tibia - surgery
Treatment Outcome
Vasoconstrictor Agents - therapeutic use
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Summary:Introduction In corrective osteotomy, wound closure is undertaken with or without deflation of the tourniquet. Hypoxia from the tourniquet causes vasodilatation associated with reactionary haemorrhage and reduced haemoglobin concentration and possibly increased blood transfusion rate. Reactionary haemorrhage and related transfusion need can be reduced through vasoconstriction from adrenaline infiltration. Method A randomized, placebo-controlled trial was done to compare adrenaline–saline solution to normal saline in the control of reactionary haemorrhage after proximal tibial osteotomy in children. Sixty-one eligible patients were divided into two groups and had corrective osteotomy under the same surgeon over a period of 7 years. Results Wound infiltration with adrenaline–saline solution 1:200,000 and normal saline was done in groups one and two, respectively. No intra-operative adverse effect was recorded. There was a 20% incidence of superficial wound dehiscence in group 1 and none in controls. The mean volume of blood in drains in the first 24 h post operation was 85 ml in group 1 and 225 ml in group 2 ( p  
ISSN:0936-8051
1434-3916
DOI:10.1007/s00402-011-1389-z