양측성 슬관절 전치환술에서의 수혈요법: 순차수술과 동시수술의 비교 (Blood Transfusion in Bilateral Total Knee Arthroplasty: Comparison between Staged and Simultaneous Surgery)

서지정보

· 발행기관 : 대한마취통증의학회
· 수록지 정보 : Anesthesia and Pain Medicine / 3권 / 1호 / 62 ~ 66페이지
· 저자명 : 정승현

초록

Background: In the case of bilateral total knee replacement
arthroplasty (TKA), surgery is performed either simultaneously or
in a staged manner. We tried to investigate the differences of blood
loss and transfusion practice between the use of simultaneous and
staged operations.
Methods: We analyzed retrospectively the medical records of 20
patients undergoing simultaneous TKA (simultaneous group), who
received autologous blood via a reinfusion system, and 20 patients
undergoing staged TKA (staged group), of which the interval is about
three weeks. We compared the amount of blood loss, and the
number of transfusions and transfusion-related complications
between the two groups of patients.
Results: Postoperative total blood loss was 2,174 ± 460 ml in
the simultaneous group and 1,850 ± 461 ml in the staged group.
There was no significant difference for transfusion (simultaneous
group 3.5 ± 1.1 units, staged group 3.9 ± 1.4 units; P ＞ 0.05).
In the simultaneous group, the volume of autologous transfusion
was 985 ± 326 ml, corresponding to 2.5 ± 0.8 units. The total
number of transfused RBC units including autologous blood was
6.1 ± 1.5 units in the simultaneous group and 3.9 ± 1.4 units in
the staged group. In the staged group, the amount of postoperative
drained blood was significantly less in the second knee operation
than that in the first knee operation (first knee surgery, 992 ± 265 ml; second knee surgery, 868 ± 260 ml: P ＜ 0.05).
Conclusions: Postoperative blood loss and total transfusion were
less in the staged TKA group of patients as compared with the
simultaneous TKA group of patients. Postoperative blood salvage
and reinfusion appear to be safe and effective for patients
undergoing simultaneous TKA.

영어초록

Background: In the case of bilateral total knee replacement
arthroplasty (TKA), surgery is performed either simultaneously or
in a staged manner. We tried to investigate the differences of blood
loss and transfusion practice between the use of simultaneous and
staged operations.
Methods: We analyzed retrospectively the medical records of 20
patients undergoing simultaneous TKA (simultaneous group), who
received autologous blood via a reinfusion system, and 20 patients
undergoing staged TKA (staged group), of which the interval is about
three weeks. We compared the amount of blood loss, and the
number of transfusions and transfusion-related complications
between the two groups of patients.
Results: Postoperative total blood loss was 2,174 ± 460 ml in
the simultaneous group and 1,850 ± 461 ml in the staged group.
There was no significant difference for transfusion (simultaneous
group 3.5 ± 1.1 units, staged group 3.9 ± 1.4 units; P ＞ 0.05).
In the simultaneous group, the volume of autologous transfusion
was 985 ± 326 ml, corresponding to 2.5 ± 0.8 units. The total
number of transfused RBC units including autologous blood was
6.1 ± 1.5 units in the simultaneous group and 3.9 ± 1.4 units in
the staged group. In the staged group, the amount of postoperative
drained blood was significantly less in the second knee operation
than that in the first knee operation (first knee surgery, 992 ± 265 ml; second knee surgery, 868 ± 260 ml: P ＜ 0.05).
Conclusions: Postoperative blood loss and total transfusion were
less in the staged TKA group of patients as compared with the
simultaneous TKA group of patients. Postoperative blood salvage
and reinfusion appear to be safe and effective for patients
undergoing simultaneous TKA.

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