Blood loss in total hip replacement

Abstract

Two hundred and twelve total hip replacements performed in one clinic over 1 year were reviewed. The mean operative time was 89 min and mean total blood loss 1090 ml. Homologous blood was administered to 74% of the patients. Blood loss was dependent on sex, body weight and height, but these correlations were eliminated when blood loss was related to estimated blood volume. There was no correlation to age. There was a positive correlation between operative time and intraoperative blood loss, but not between any of these factors and postoperative blood loss. Operative time varied significantly between surgeons, but there was no correlation between surgeon's experience and operative time or blood loss. Despite a mean of only 12 total hip replacements per surgeon, both operative time and blood loss were small compared to what was found in other studies. The use of a posterior approach is believed to contribute to a shorter operative time as well as to moderate blood loss. Intraoperative blood loss was less under epidural than under general anaesthesia, but in contrast to others we found higher postoperative blood loss after epidural anaesthesia.

General Compared with Spinal Anesthesia for Total Hip Arthroplasty

“…This relationship has been repeatedly described in the hip arthroplasty literature 4,5,7,[21][22][23][24][25][26][27][28][29] . Blood loss during total hip arthroplasty performed under general anesthesia is often a function of how well a low blood pressure is maintained during the procedure 28 .…”

Predictors of Perioperative Blood Loss in Total Joint Arthroplasty

“…As a result, peripheral resistance, especially in the region affected by the spinal anesthesia, decreases. Consequently, blood pressure decreases and the vasomotor paralysis and atony result in bleeding that is slow and can be controlled easily 31,32 . By considering the role of controlled hypotensive anesthesia in reducing intraoperative blood loss, hypertension may increase blood loss, as was found in this study.…”

Blood Product Utilization in Hip and Knee Arthroplasty: Effect of Gender and Autologous Blood on Transfusion Practice

“…Instead of volume of red cells replaced, a more relevant comparison may be the percent of red cell vol ume replaced. In a recent study of blood loss during THR surgery, blood loss correlated with gender and was 27% lower in females [11]. However, when blood loss was nor malized to red cell volume, both genders lost a similar percent of red cell volume.…”