Cocktail therapy reduces hidden blood loss after total hip arthroplasty

Shi Li-jun; Bai Yu; Gao Fu-qiang; Sun Wei; Wang Wei-guo; Cheng Li-ming; Guo Wan-shou

doi:10.3969/j.issn.2095-4344.2016.48.002

Abstract：BACKGROUND:Epinephrine solution, tranexamic acid, hemostatic gels and powders have been used to reduce topical blood loss after total hip arthroplasty;however, none of these methods alone is sufficient. OBJECTIVE:To evaluate the efficacy of cocktail therapy on blood loss and transfusion rate after unilateral total hip arthroplasty. <br> METHODS:125 patients with avascular necrosis of the femoral head were randomly divided into two groups. Al patients received primary unilateral total hip arthroplasty. In the cocktail therapy group (n=64), cocktail (3 g of tranexamic acid and 0.25 mg diluted epinephrine solution) was intraarticlarly injected after musculoaponeurotic surgical closure. In the tranexamic acid group (n=61), physiological saline containing 3 g tranexamic acid was intraarticlarly injected after musculoaponeurotic surgical closure. Blood loss and transfusion rate were analyzed on postoperative days 1, 3, 5, and deep venous thrombosis and pulmonary embolism were fol owed up. <br> RESULTS AND CONCLUSION:Total blood loss, hidden blood loss and hemoglobin loss were lower in the cocktail therapy group than in the tranexamic acid group (P<0.05). There was no significant difference in intraoperative blood loss and transfusion rate between the two groups. No incision infection, sudden excessive increases in blood pressure, symptomatic deep venous thrombosis, pulmonary embolism, or tranexamic acid-related complications was detected in either group. These results suggested that topical application of cocktail wine in total hip arthroplasty can effectively decrease postoperative hidden blood loss without serious adverse reaction or substantial complications.