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  • Title: Blood-sparing efficiency of transdermal nitroglycerine during open fixation of femur shaft fractures: a randomized, double-blind study.
    Author: Kazemi AP, Zand F, Sedaghat M.
    Journal: J Clin Anesth; 2006 Nov; 18(7):495-8. PubMed ID: 17126776.
    Abstract:
    STUDY OBJECTIVES: To evaluate the effect of transdermal nitroglycerine for reducing blood loss during open fixation of femur shaft fractures. DESIGN: Randomized, double blind, clinical trial. SETTING: University-affiliated hospital. PATIENTS: 60 ASA physical status I and II patients undergoing elective open fixation of femur shaft fractures. INTERVENTIONS: Patients were randomized to two groups: those who received 3-in (7.5 cm) transdermal nitroglycerine (group N) or 3-in (7.5 cm) placebo (group P). All the drugs used for induction and maintenance of anesthesia were similar in both groups and administered according to the patient's weight. MEASUREMENTS: In both groups, baseline heart rate and blood pressure were recorded and then measured every 5 minutes thereafter. Routine estimation, as well as a mathematical model of blood loss calculation, was used to determine intraoperative blood loss. MAIN RESULTS: Group N had a significant lower systolic, diastolic, and mean arterial blood pressure than those of group P during the operation. The mean estimated blood loss in group N (443.4 +/- 158.0 mL) was significantly lower than that in group P (950.0 +/- 554.9 mL). The calculated blood loss (622.7 +/- 192.4 mL) in group N was also significantly lower than that in group P (1232.1 +/- 630.4 mL). CONCLUSION: By inducing moderate hypotension, the use of transdermal nitroglycerine decreases intraoperative blood loss and the need for transfusion.
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