The effect of aprotinin on inflammatory response to intraoperative blood salvage using cell saver in patients undergoing spinal surgery / 中华麻醉学杂志

ABSTRACT

Objective To investigate the effect of aprotinin on the inflammation response to reinfusion of shed blood during operation after being aspirated, filtered and washed using cell saver.Methods Twenty-four ASA I - II patients undergoing elective spinal surgery under general anesthesia were randomly divided into 2 groups aprotinin group ( n = 12) and control group ( n = 12) .The patients were premedicated with intramuscular pentobarbital 0.1 g and atropine 0.5 mg. Anesthesia was induced with propofol 2 mg ? kg -1 , fentanyl 2-4 ?g ? kg-1 and vecuronium 0.1-0.3 mg ? kg-1 and maintained with isoflurane, propofol infusion and intermittent i. v. boluses of fentanyl and vecuronium. The patients were mechanically ventilated after tracheal intubation. In aprotinin group aprotinin 10 ? 105 IU was given before skin incision and another dose of aprotinin 10 ? 105 IU was continuously infused during operation. The blood shed during operation was collected, anticoagulated with heparin, filtered, washed and reinfused using AutoLog cell saver. Blood samples were taken from CVP line before skin incision (T1 , baseline), 30 min after reinfusion of salvaged bloods (T2) and at the end of operation (T3 ) for WBC and neutrophil granulocyte counts and determination of expression of CD11b and CD18 on the surface of neutrophil granulocytes using flow cytometry. Results The two groups were similar with respect to the general condition of the patients, duration of operation and account of shed blood reinfused. (676? 353) ml was reinfused in control group. The expression of CD11b and CD18 on the surface of neutrophil granulocytes increased significantly at T2 and T3 as compared to the baseline at T1 in control group ( P