[Aprotinin 2 million KIU reduces perioperative blood loss in patients undergoing primary total hip replacement]

We investigated consecutive patients undergoing primary total hip replacement surgery who were randomly assigned into two groups; those who received a blinded solution of aprotinin 2 million KIU (kallikrein inactivation units) (n = 11) and those who received an equivalent volume of normal saline placebo (n = 10) throughout the surgical procedure. Anesthesia and surgical techniques were standardized. All patients received spinal anesthesia combined with general anesthesia. There was no significant difference in blood loss during operation between the two groups. However, postoperative blood loss in the aprotinin group (284 +/- 155g, mean +/- SD) was significantly less compared with that in the control group (723 +/- 334g). Total blood loss in the aprotinin group (820 +/- 255g) was also significantly less than in control group (1265 +/- 389g). We conclude that the use of aprotinin 2 million KIU during total hip replacement results in significantly less perioperative blood loss, especially during the postoperative period.