Comparison of aprotinin and tran-x-amic acid in adult scoliosis correction surgery.

By London Spine

Comparison of aprotinin and tran-x-amic acid in adult scoliosis correction surgery.

Eur Spine J. 2012 Mar 9;

Authors: Khurana A, Guha A, Saxena N, Pugh S, Ahuja S

Abstract
PURPOSE: A retrospective review of consecutive adult patients undergoing scoliosis correction surgery was performed to compare the effects of aprotinin and tran-x-amic acid in blood conservation and to define a comprehensive blood conservation strategy for such surgery. METHODS: Medical records of all patients who underwent scoliosis correction surgery in this unit between January 2003 and December 2008 were reviewed. The patients were divided into three cohorts: group 1 receiving no antifibrinolytics, group 2 aprotinin and group 3 tran-x-amic acid. Information was collected regarding number of vertebral levels fused, pre- and post-operative haemoglobin, intra-operative blood loss and peri-operative autologous and allogenic blood transfusion performed. RESULTS: Aprotinin was used in 28 patients (38%), tran-x-amic acid in 26 (36%), while 19 (26%) received no antifibrinolytics. 21 patients had anterior surgery, 34 patients had posterior surgery and 18 had combined anterior and posterior procedures. Mean blood loss in the patients who received aprotinin and tran-x-amic acid was 710 and 738 ml, respectively. This was significantly less than the patients receiving no antifibrinolytics (972 ml, p = 0.037). Blood transfusion was required in only two patients undergoing anterior correction surgery. CONCLUSION: Aprotinin and tran-x-amic acid reduce blood loss in adult spinal deformity correction surgery. With aprotinin being unavailable for clinical use, we recommend the use of tran-x-amic acid along with other blood conservation measures for adult spinal deformity correction surgery.

PMID: 22402839 [PubMed – as supplied by publisher]