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Use of intravenous Premarin to decrease postoperative blood loss after pediatric scoliosis surgery
1Shriners Hospitals for Children, Shreveport, Louisiana, USA.
Insights
Conjugated estrogens (Premarin) significantly reduced blood loss in pediatric spinal surgery patients by 37%. This study shows Premarin is effective in decreasing postoperative drainage in this population.
Area of Science:
- Pediatric Surgery
- Pharmacology
- Hemostasis
Background:
- Conjugated estrogens (Premarin) are known for their hemostatic effects.
- Previous research has not evaluated Premarin's efficacy in reducing blood loss during pediatric spinal procedures.
Purpose of the Study:
- To assess the effectiveness of intravenously administered Premarin in reducing postoperative Hemovac drainage.
- To quantify the impact of Premarin on blood loss in adolescent patients undergoing spinal surgery.
Main Methods:
- A study involving 64 adolescent patients undergoing spinal surgery.
- 32 patients received 1 mg/kg of Premarin intravenously postoperatively; 32 served as controls.
- Hemovac drainage was measured over 48 hours post-surgery.
Main Results:
- Patients receiving Premarin showed a 37% decrease in Hemovac drainage volume (mL/kg).
- A statistically significant reduction in postoperative bleeding was observed in the Premarin group.
- No complications were reported with Premarin administration.
Conclusions:
- Intravenous Premarin administration effectively reduces postoperative blood loss in pediatric spinal surgery.
- Premarin offers a safe and effective option for managing blood loss in this patient group.
Study Design:
The hemostatic effect of conjugated estrogens (Premarin, Wyeth-Ayerst Laboratories, Philadelphia, PA) has been reported in the literature, but no study has investigated its effectiveness in decreasing blood loss in pediatric spinal procedures.
Objective:
To determine the effectiveness of intravenously administered Premarin in the immediate postoperative period in decreasing Hemovac drainage postoperatively.
Methods:
Sixty-four adolescent patients undergoing spinal surgery, both posterior and anterior/posterior procedures, were studied. Thirty-two patients served as control subjects. The other 32 received Premarin, 1 mg/kg intravenously in the immediate postoperative period. Hemovac drainage was measured during a period of 48 hours.
Results:
In measuring Hemovac drainage for 48 hours in both groups, there was a 37% decrease in the volume of the postoperative drainage (mL/kg) in the patients receiving Premarin postoperatively. Measurement of adjusted volumes (mL/kg) revealed a statistically significant decrease in postoperative bleeding after administration of Premarin.
Conclusions:
Administration of Premarin resulted in a 37% decrease in the volume of postoperative drainage (mL/kg) without complications. Premarin appears to be effective in decreasing postoperative blood loss in a pediatric postoperative spinal population.