Total Diz Artroplastisinde Cerrahi Yara Kapatılması Öncesinde Kontrollü Arteriyel Hipertansiyon ile Yapılan Hemostazis Kanama Miktarını ve Transfüzyon İhtiyacını Etkiler mi?

Abstract

Objective: We aimed to assess the efficacy of hemostasis while controlled augmentation of arterial blood pressure before surgical closure after total knee arthroplasty (TKA). 
 Materials and Methods: This retrospective cohort involved data collected from the medical files of 87 patients (62 women, 25 men) who underwent TKA using hypotensive epidural anesthesia (HEA). Patients were allocated into two groups. Group I (n=44) received HEA, while Group II (n=43) had controlled arterial hypertension before surgical closure. Perioperative hemoglobin and hematocrit levels, systolic and diastolic blood pressure, and the amount of erythrocyte suspension transfusion were compared between the two groups. 
 Results: The average age of our series was 66.41 ± 6.17 (range: 57-78) years. Notably, the amount of bleeding on postoperative 1st, 2nd, 4th, 12th, and 24th (p=0.031, 0.032, 0.001, 0.001, 0.001, respectively) hours was significantly less in Group II. There were no significant differences between the two groups for complications, operative duration, perioperative bleeding, duration of follow-up and hospitalisation, and compared descriptives. 
 Conclusion: Our data indicated that controlled elevation of mean arterial pressure before surgical closure might allow the achievement of meticulous hemostasis after TKA. Further prospective, randomised, controlled trials on more extensive series are warranted to verify our preliminary results.