Abstract
BackgroundHypothermia related to anaesthesia and operating theatre environment is associated with increased blood loss in a number of surgical disciplines, including total hip arthroplasty. The influence of patient temperature on blood loss in total knee arthroplasty (TKA) has not been previously studied.MethodsWe recorded patient axillary temperature in the peri-operative period, up to 24 h post-operatively, and analysed the effect on transfusion rate and blood loss from a consecutive cohort of 101 patients undergoing primary TKA.ResultsNo relationship between peri-operative patient temperature and blood loss was found within the recorded patient temperature range of 34.7–37.8 °C. Multivariable analysis found increasing age, surgical technique, type of anaesthesia and the use of anti-platelet and anticoagulant medications as significant factors affecting blood loss following TKA.ConclusionPatient temperature within a clinically observed range does not have a significant impact on blood loss in primary TKA patients. As long as patient temperature is maintained within a reasonable range during the intra-operative and post-operative periods, strategies other than rigid temperature control above 36.5 °C may be more effective in reducing blood loss following TKA.
Highlights
Blood loss during joint arthroplasty surgery can be significant and substantial, rendering the patient at risk of requiring an allogenic blood transfusion
Our aim was to determine if peri-operative body temperature affects blood loss during total knee arthroplasty (TKA)
Measuring blood loss through intra-operative suction volume, post-operative drainage and post-operative change in haemoglobin, no difference could be demonstrated in patients with temperatures below 36 °C compared to patients with a normal temperature above 36.5 °C
Summary
Blood loss during joint arthroplasty surgery can be significant and substantial, rendering the patient at risk of requiring an allogenic blood transfusion. Recent data has demonstrated arthroplasty and fracture surgery to account for 9.8 % of all transfused red blood cell units It was the number one reason for transfusion in patients undergoing surgery, second only to haematology and oncology when considering all medical subspecialties [1]. Every effort should to be made to reduce the Anaesthetic agents impair the control of body temperature and in combination with operating room temperature are largely responsible for the hypothermia associated with surgery. These agents result in loss of thermoregulatory controls through reduction of shivering and vasoconstriction [2,3,4,5]. The influence of patient temperature on blood loss in total knee arthroplasty (TKA) has not been previously studied
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