Journal of Isfahan Medical School

Journal of Isfahan Medical School

Reduction of Intraoperative Bleeding with Fibrinogen Administration in Posterior Spinal Fusion Surgery

Document Type : Original Article (s)

Authors
Alireza Pournajafian 1
Mohammadreza Ghodraty 2
Masood Mohseni 3
Ali Akbar Ghamari 4
Farahnaz Sadeghi 4
1 Assistant Professor, Department of Anesthesiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
2 Associate Professor, Department of Anesthesiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
3 Assistant Professor, Department of Anesthesiology, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
4 Resident, Department of Anesthesiology, School of Medicine AND Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
Abstract
Background: Spinal surgeries are frequently complicated with high rate of intra- and post-operative hemorrhage. It is shown that the serum fibrinogen level is a pivotal factor in determining the degree of intra- and post-operative hemorrhage. This study sought to examine the effect of prophylactic infusion of fibrinogen in preventing hemorrhage in candidates for posterior spinal fusion surgery.Methods: 41 patients who were candidates for posterior spinal fusion surgery were randomly devided in two groups of intervention (21 patients) and control (20 patients), receiving either infusion of fibrinogen (1 g in 100 cc of normal saline infused within 5 minutes after induction) or placebo, respectively. Changes in serum hemoglobin and fibrinogen, the severity of intraoperative hemorrhage, and the need for blood transfusion were compared between the two groups.  Findings: While pre- and postoperative changes in serum hemoglobin and fibrinogen did not differ significantly between the two groups, the mean blood loss (533.3 ± 157.9 vs. 679.0 ± 130.0 ml, P = 0.003) and the need for blood transfusion (0 vs. 30 percent, P = 0.030) were significantly higher in the control group.Conclusion: Prophylactic infusion of fibrinogen in candidates for posterior spinal fusion surgery may significantly decrease the amount of intra-operative hemorrhage and the need for blood transfusion.
Keywords
Fibrinogen
Hemorrhage
Posterior spinal fusion surgery
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Journal of Isfahan Medical School
Volume 33, Issue 347 - Serial Number 347
July and August 2015
Pages 1370-1379

  • Receive Date 12 May 2015
  • Accept Date 06 April 2022