Abstract
Introduction: The intra-operative blood-loss data on scoliosis surgery patients at Dunedin Hospital during 1992–2000 were analysed retrospectively. Various measures had been tried to reduce the intra-operative blood loss and included use of fibrinogen, DDAVP and antifibrinolytic agents. Patients with medical abnormalities, particularly those with muscular dystrophies/myopathies appeared to have a high incidence of intra-operative blood loss.
Aim: To evaluate the amount of bleeding. any pre-operative factors identifiable as contributing to the bleeding and any preventive measures which have been identified.
Methods: An audit of intra-operative blood loss on all cases presented for corrective surgery for scoliosis in Dunedin Hospital during the period 1992–2000 was undertaken.
Results: A total of 160 operations were performed during the eight years. The mean age of the cohort was 14.8 years (SD 6.8) and the mean weight of the cohort was 44kg (SD 18.9). Fifty-six percent of the patients were idiopathic cases with no medical abnormalities, where as 44% had congenital/medical abnormalities.
The mean blood loss as a percentage of calculated blood volume was 38% (SD 35). There was a strong suggestion that patients with medical abnormalities, particularly those with muscular dystrophies, had much higher blood losses (63%, SD 59). There were no differences between the different patient groups in the pre-operative haematological investigations.
Conclusions: We have noted a definite overall improvement in the amount of blood loss since 1995. The reasons included intra-operative monitoring of coagulation factors, early use of fibrinogen, use of DDAVP and antifibrinolytic agents.
The abstracts were prepared by Professor A. J. Thurston. Correspondence should be addressed to him at the Department of Surgery, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand
