[Transfusion for operation: reduction and proper preparation of blood for transfusion]

In order to minimize preoperative transfusion requirements and to order proper preoperative transfusion blood, we induced deliberate hypotension and analyzed preoperative preparation of blood with C/T (cross-match/transfusion) ratio. We tried to establish a maximum surgical blood order schedule (MSBOS) based on the surgical transfusion experience of about 10 operations at our hospital. Deliberate hypotension was induced with prostaglandin E1 (PGE1) in 14 patients with mastectomy. Bleeding volume in PGE1 group (n = 7) was reduced to approximately 50% of control group (n = 7) at average dose of 35 +/- 25 ng.kg-1.min-1 with enough urine output. The dose of PGE1 was smaller than other reports because of the application of continuous epidural block to general anesthesia in all cases. Average C/T ratio was 4.6 and it was 3.6-24 in the 10 operations, which are higher than recommended value of the Ministry of Health and Welfare as well as ASA committee. We confirmed deliberate hypotension with PGE1 and continuous epidural block under general anesthesia were useful to minimize blood loss during mastectomy and clarified the improvement of the present preoperative blood ordering.