"Blood loss and tourniquet in total knee replacement surgery: A randomised control study"

Abstract

BackgroundThe primary aim of the study was to determine the efficiency of tourniquet in reduction of blood loss during Total Knee Arthroplasty. MethodA total of 105 patients were randomised into two groups each consisting of 52 patients in one group and 53 in another. Pre-operative Haemoglobin (Hb) and Packed Cell Volume (PCV) measurement was done in every case. Every individual received Injection Tranexamic acid 1gm slow intravenous infusion before incision was given and one dose after 8hrs post-surgery. Meticulous care was taken to measure blood loss during surgery. A drain was placed in every case and removed after 24 h. Amount of blood loss in the drain was measured and post-operative Hb and PCV levels were ordered. ResultsNo statistically significant difference in the amount of total blood loss was found between the two groups. However, the amount of blood loss during surgery was significantly lesser in patients who underwent surgery with tourniquet in comparison to patients who were operated without tourniquet. At the same time blood loss through drain during post op period was clearly found to be more in patients who were operated with tourniquet as compared to another group. ConclusionOur study concludes that there is no impact on blood loss as a result of tourniquet use in total knee arthroplasty. The study further proved that the decrease in blood loss during surgery with the use of tourniquet is associated with proportionate rise in blood loss in the post op period from the drain. Furthermore, our study concluded that optimisation of patient’s pre surgery blood parameters can eliminate the need for post op transfusion.