The Effect of Low Dose Aprotinin in Patients with Adolescent Idiopathic Scoliosis Undergoing Posterior Spinal Fusion

Park, Hae Gyun; Yoo, Byung Hoon; Lee, Sangseok; Yon, Jun Heum; Hong, Ki Hyuk

Clinical Research

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2008;3(3):178-182.
Published online July 30, 2008.

The Effect of Low Dose Aprotinin in Patients with Adolescent Idiopathic Scoliosis Undergoing Posterior Spinal Fusion

Hae Gyun Park, Byung Hoon Yoo, Sangseok Lee, Jun Heum Yon, Ki Hyuk Hong

Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea. twowind@sanggyepaik.ac.kr

Abstract

BACKGROUND
Aprotinin is a kallikrein inhibitor at high doses and a plasmin inhibitor at low doses. Low-dose aprotinin has been shown to reduce transfusion requirements in patients undergoing liver resection, open-heart surgery, and spine deformity surgery. The aim of this study was to evaluate the effect of low-dose aprotinin on perioperative blood loss and on transfusion requirements in adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion. METHODS: We studied forty patients who were set to undergo posterior spinal fusion. Twenty patients were given aprotinin, and twenty control patients were not given aprotinin. Patients were assessed for pre- and post-operative hemoglobin, hematocrit, platelet count, blood urea nitrogen, and creatinine. Perioperative blood loss was measured through suction drains and gauze, and transfusion requirements were recorded. RESULTS: Upon comparing the aprotinin and control groups, we found no differences in intraoperative blood loss (1,456 +/- 622 ml vs 1,625 +/- 738 ml, respectively, [P = 0.17]), total (intraoperative and 24 h postoperative) blood loss (2,544 +/- 977 ml vs 2,594 +/- 783 ml, respectively, [P = 0.42]), or homologous transfusion requirements (1,672 +/- 1,077 ml vs 1,520 +/- 718 ml packed RBCs, respectively, [P = 0.52]). Renal function was maintained in both groups. CONCLUSIONS: Low-dose aprotinin does not decrease blood loss or transfusion requirements in AIS patients undergoing posterior spinal fusion. Renal function was maintained in both the aprotinin and control groups.

Key Words: aprotinin, adolescent idiopathic scoliosis, posterior spinal fusion