Purpose: To determine the effectiveness of a postoperative autologous blood reinfusion system, as an alternative to homologous, banked blood transfusions in total hip arthroplasty.

Material and Methods: We have carried out a prospective randomized, controlled study on 60 patients having unilateral total hip replacement. In all these patients the same surgical team applied the same surgical technique (hybrid THA) and they follow the same rehabilitation program. All the patients received intraoperatively one or two units of homologous banked blood transfusion (average 1.7 units/patient) according to the volume of blood collected in the suction device and to the anaesthesiologist’s estimation. In 30 of these patients (group A) a reinfusion system of unwashed blood salvaged was applied and they supplemented postoperatively with banked blood transfusions when required. A control group of 30 patients (group B), in whom standard suction drains were used, received also additional blood transfusions when required. The admission of banked blood transfusions determined by haemoglobin value (< 9mg/dL) and/or clinical signs (blood pressure, pulses, etc). The value of haemoglobin, haematocrite and platelets recorded preoperatively and the 1st, 5th and 15th day after operation.

Results: 13 patients of group A required postoperatively 13 units of homologous blood (0.43 units/patient) (total amount for group A 64 banked blood units or 2.14 units/patient). 21 patients of group B required additional 28 banked blood units postoperatively (totally 79 units for group B or 2.63 units/patient). In the study group the total homologous blood requirements reduced by 20%, while the postoperative blood requirements reduced by 54% and the number of patients required additional blood transfusion reduced by 38%. There was no significant difference in the postoperative haematocrite and haemoglobin values between the two groups. None of the patients developed any adverse reactions after reinfusion.

Conclusions: The use of an autologous blood reinfusion system reduces effectively the postoperative demands of homologous banked blood transfusion in total hip arthroplasty.

Purpose: The purpose of our study is to estimate the effectiveness of Parecoxib in the post surgical analgesia in the fractures of the hip joint in comparison with the usage of the combination of Diclofenac ant Pethidine

Material and methods: We have carried out a prospective randomized clinical study, during the period January 2003-July 2004, on 90 patients were operated with fractures of the hip joint. We examined two similar groups of patients concerning the age, the type of fracture and the type of anaesthesia. In group A, consisting of 35 patients, we provided 40 mg of Parecoxib i.v., as postsurgical analgesia, twice a day and in Group B, of 55 patients, we provided the combination of Diclofenac 75mg i.m. twice a day and Pethidine i.m. in case of persisting pain.

The intensity of pain was estimated by the Pain Intensity Scale ( PIS ).

Results: In Group A the PIS was 2.5 ± 0.8, and none of the patients needed supplementary analgesic. In Group B the PIS was 3.2 ± 0.8 and 21 (38.3%) patients needed supplementary analgesics (Pethidine).

In the use of Parecoxib no side effects were noticed (decrease BP, vomiting etc).

Conclusion: Parecoxib is more effective in the post surgical analgesia than Diclofenac and Pethidine in the fractures of the hip joint. It is easier to administer (i.v) and is also seems to be safe (no side effects were noticed). Therefore, we suggest that it should be the drug of choice in the post surgical analgesia of the fractures of the hip joint.