[Can the salvaged autologous blood transfusion be safe during TIVA?]

This study aimed to determine whether the salvaged blood can be safely used after surgery and to examine the blood concentration of anesthetics in salvaged blood processed by autologous transfusion device (Cell Saver 5, Haemonetics Corp.) during propofol anesthesia.

Ten consenting patients (aged 48-79 yr, classified ASA physical status I or II) scheduled for total hip arthroplasty were randomly divided into two groups: in the first group, slowing pattern of electroencephalographic activity (moderate-dose group: M) was obtained and in the second group, a burst-suppression (high-dose group: H) was obtained. Employing the electroencephalogram (EEG) and spectral edge frequency, propofol was titrated to maintain the EEG pattern. All patients received propofol anesthesia combined with lumbar epidural anesthesia.

The infusion rates of propofol at the end of surgery were 9.6 +/- 1.1 (H) and 7.0 +/- 1.4 mg.kg-1.h-1(M), respectively. The blood concentration of propofol in the H group was significantly greater than that in the M group. But no significant difference was observed in the salvaged blood concentration of propofol between the two groups (H: 0.391 +/- 0.158 microgram.ml-1, M: 0.401 +/- 0.236 microgram.ml-1).

The concentrations of propofol in salvaged blood were low, irrespective of the different infusion rates. These results demonstrate that salvaged autologous blood would not contribute to sedative or anesthetic effect.