Experience with isovolemic hemodilution in extensive head and neck surgery

Isovolemic hemodilution was performed on 30 American Society of Anesthesiologists (ASA) class I patients during extensive surgical procedures in the head and neck region using 3.5% polygeline (Haemaccel, Hoechst) as hemodiluent. The mean total surgical blood loss was 831.66 +/- 291.04 ml, and mean total blood drained was 1021.66 +/- 187.38 ml. The heart rate, mean arterial pressure, and central venous pressure showed insignificant variation. Fall in packed cell volume and hemoglobin was highly significant with hemodilution and with retransfusion. The values increased and were comparable to pre-hemorrhage values on the day of discharge. No significant change was found in arteriovenous oxygen saturation difference and arteriovenous oxygen content difference. The need for homologous blood transfusion was avoided in all patients. There was no significant complication in terms of wound healing or flap necrosis. The technique was found to be safe, and therefore, we recommend this in all extensive surgical procedures in the head and neck region in patients deemed to be fit for the procedure.