Effects of the Preoperative Administration of Fibrinogen on Intraoperative Bleeding in Pelvic Surgeries

Abstract

Background: Orthopedic surgeries are frequently complicated with a high amount of intra-operative hemorrhage, and this bleeding has a direct effect on the results of these operations. Objectives: This study evaluated the effect of preoperative administration of fibrinogen on intraoperative bleeding in pelvic surgeries. Methods: This study was a double-blinded, randomized clinical trial. Forty-two patients were randomly divided into two groups of fibrinogen and placebo. Hemoglobin, platelet, and fibrinogen levels were measured in all patients before surgery. In the intervention group, the patients received 1 gr. of fibrinogen after the induction of anesthesia. In the control group, the patients received the same volume of normal saline. All data on bleeding, transfused blood, blood pressure, duration of surgery, hemoglobin, platelet, and fibrinogen levels were recorded during a 24-hour period after surgery. Results: There was no significant difference in terms of age and sex between the groups (P > 0.05). There was no significant difference between hemoglobin, blood transfusion rate, international normalization ratio (INR), prothrombin time (PT), and partial thromboplastin time (PTT) in the two study groups (P > 0.05). Patients' bleeding rate was significantly lower in the fibrinogen group (1328.57 ± 227.8 mL) than in the placebo group (1610 ± 479.58 mL) (P < 0.05). However, there was no significant difference between serum levels of fibrinogen before and after surgery in both groups (P > 0.05). Conclusions: Although prophylactic injection of fibrinogen did not decrease the rate of blood transfusion to the patients in pelvic surgeries, it resulted in a significant bleeding reduction.