The Effects of Preemptive Analgesia to Blood Transfusion in Total Knee Arthroplasty / 대한수혈학회지

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) is associated with moderate to severe postoperative pain. In recent studies, preemptive analgesia was useful for control of postoperative pain in patients undergoing TKA. In particular, cyclooxygenase-2 inhibitor (celecoxib) is recommended for preemptive analgesia. As a large amount of blood is lost during TKA, blood transfusion is often required. In this study, we evaluated the difference of intraoperative blood loss, complications of operation, and hemodynamic change between the celecoxib group and the control group in TKA surgeries. METHODS: A total of 58 patients who underwent TKA from January 2013 to June 2013 in our hospital were evaluated through a retrospective study. Patients in the celecoxib group received 200 mg of oral celecoxib 1 to 2 hours before TKA. Those in the control group received no medication 1 to 2 hours before TKA. Preoperative and postoperative hemoglobin level, estimated blood loss, infused fluid volume, and intraoperative complications (nausea, vomiting) were assessed. Mean blood pressure was recorded immediately, and 30, 60, and 90 minutes after spinal anesthesia, after transfer to the post anesthesia care unit. RESULTS: No significant differences in demographic data (age, height, weight, operation time, nausea, and vomiting) were observed between the two groups. The intraoperative fluid volume of the celecoxib group was lower than that of the control group (782.8+/-240.6 vs 1382.4+/-369.2; P<0.05). No differences in hemodynamic changes (intraoperative blood pressure) were observed between the two groups. CONCLUSION: Perioperative use of an inhibitor of cyclooxygenase 2 is an effective component of multimodal analgesia, which has no effect on hemodynamic change and side effects during TKA.