scholarly journals Pre-Operative Oral Iron Supplementation Reduces Blood Transfusion in Colorectal Surgery – A Prospective, Randomised, Controlled Trial

2007 ◽  
Vol 89 (4) ◽  
pp. 418-421 ◽  
Author(s):  
PG Lidder ◽  
G Sanders ◽  
E Whitehead ◽  
WJ Douie ◽  
N Mellor ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Colorectal Surgery ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Controlled Trial ◽  
Ferrous Sulphate ◽  
Haemoglobin Concentration ◽  
Treated Group ◽  
Operative Blood Loss ◽  
Randomised Controlled

INTRODUCTION Allogeneic blood transfusion confers a risk to the recipient. Recent trials in colorectal surgery have shown that the most significant factors predicting blood transfusion are pre-operative haemoglobin, operative blood loss and presence of a transfusion protocol. We report a randomised, controlled trial of oral ferrous sulphate 200 mg TDS for 2 weeks' pre-operatively versus no iron therapy. PATIENTS AND METHODS Patients diagnosed with colorectal cancer were recruited from out-patient clinic and haematological parameters assessed. Randomisation was co-ordinated via a telephone randomisation centre. RESULTS Of the 49 patients recruited, 45 underwent colorectal resection. There were no differences between those patients not receiving iron (n = 23) and the iron-supplemented group (n = 22) for haemoglobin at recruitment, operative blood loss, operation duration or length of hospital stay. At admission to hospital, the iron-supplemented group had a higher haemoglobin than the non-iron treated group (mean haemoglobin concentration 13.1 g/dl [range, 9.6–17 g/dl] versus 11.8 g/dl [range, 7.8–14.7 g/dl]; P = 0.040; 95% CI 0.26–0.97) and were less likely to require operative blood transfusion (mean 0 U [range, 0–4 U] versus 2 U [range, 0–11 U] transfused; P = 0.031; 95% CI 0.13–2.59). This represented a cost reduction of 66% (47 U of blood = £4700 versus oral FeSO4 at £30 + 15 U blood at £1500). At admission, ferritin in the iron-treated group had risen significantly from 40 μg/l (range, 15–222 μg/l) to 73 μg/l (range, 27–386 μg/l; P = 0.0036; 95% CI 46.53–10.57). CONCLUSIONS Oral ferrous sulphate given pre-operatively in patients undergoing colorectal surgery offers a simple, inexpensive method of reducing blood transfusions.

scholarly journals Guillotine versus dissection tonsillectomy: randomised, controlled trial

2012 ◽  
Vol 126 (11) ◽  
pp. 1142-1149 ◽  
Author(s):  
S J Frampton ◽  
M J A Ward ◽  
V S Sunkaraneni ◽  
H Ismail-Koch ◽  
Z A Sheppard ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Blood Loss ◽  
Operative Time ◽  
Controlled Trial ◽  
Operative Blood Loss ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Secondary Haemorrhage ◽  
Randomised Controlled ◽  
Cold Steel Dissection

AbstractObjective:This trial aimed to compare the guillotine technique of tonsillectomy with ‘cold steel’ dissection, the current ‘gold standard’.Design:A single centre, randomised, controlled trial.Methods:One hundred children aged 3 to 11 years who were listed for bilateral tonsillectomy were recruited. Patients had one tonsil removed by each technique, and were blinded to the side. The operative time, intra-operative blood loss, haemostasis requirement and post-operative pain scores were recorded and compared.Results:Operative time and intra-operative blood loss were both significantly less for the guillotine technique (p < 0.001) and there was a significantly reduced haemostasis requirement (p < 0.001). Pain was also less on the guillotine side (p < 0.001). There were no tonsillar remnants or palatal trauma for either technique. There was no significant difference between techniques in the frequency of secondary haemorrhage.Conclusion:This study provides level Ib evidence that guillotine tonsillectomy in children with mobile tonsils is an effective and time-efficient procedure which produces less intra-operative blood loss and post-operative pain than cold steel dissection.

scholarly journals Effect of Diluted Vasopressin vs Saline on Intraoperative Blood Loss during Vaginal Hysterectomy- A Randomised Controlled Trial

2021 ◽  
Author(s):  
Vinika Nimodia ◽  
Sandhya Jain ◽  
Shalini Rajaram ◽  
Asha Tyagi ◽  
Bindiya Gupta
Keyword(s):  
Randomised Controlled Trial ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Controlled Trial ◽  
Saline Group ◽  
P Value ◽  
Intraoperative Blood Loss ◽  
Group I ◽  
Randomised Controlled

Introduction: Vasopressin has been used to control blood loss in gynaecological surgeries such as in myomectomy, abdominal hysterectomy etc. Only few studies have demonstrated its efficacy in Vaginal Hysterectomy (VH) in reducing intraoperative blood loss. VH is frequently performed gynaecological surgery in safe lower dose of vasopressin. There is no consensus on dose of infiltration. Aim: To compare submucosal vasopressin vs saline infiltration during VH and assess surgical parameters i.e., intraoperative blood loss, postinfiltration vitals, ease of dissection, use of electrocautery, need of blood transfusion and complications. Materials and Methods: This randomised controlled trial was done in department of Obstetrics and Gynaecology in collaboration with Department of Anaesthesia from November 2017 to April 2019. Low risk women aged <65 years with Pelvic Organ Prolapse Quantification-Stage (POP-Q stage) III/IV prolapse were recruited from Outpatient Department (OPD). They were randomised into two groups. Group I (n=35) patients received submucosal infiltration with diluted vasopressin (40mL vasopressin of 0.1U/mL, total 4U), prior to the incision. Group II (n=35) patients received 40cc of normal saline. Vitals were checked at one and five minutes postinfiltration. All the qualitative parameters were compared between the two groups by chi-square test and quantitative parameters by unpaired t-test. Inter and intragroup comparison was done by Repetitive Measure ANOVA followed by Tukey’s test. For the parameters, which did not follow the Gaussian distribution, were compared by non-parametric Mann-Whitney test between the two groups. A p-value <0.05 was considered as significant. All the data analysis was carried out in Statistical Package for the Social Sciences (SPSS) version 20.0. Results: The mean estimated blood loss from incision till creation of flaps was half in vasopressin group as compared to saline group (21.33 mL vs 49.67 mL, p-value=0.001). Vasopressin group had less use of electrocautery, whereas ease of dissection was more in saline group. There was no significant difference in duration of surgery till flap creation and need of blood transfusion. There was fall in pulse rate and Blood Pressure (BP) in both groups which did not require medical intervention and was likely due to neuraxial anaesthesia. Conclusion: Vasopressin appears to be safe and effective in VH at infiltration dose of four units in dilution. However further studies on larger sample size are recommended to gather more evidence in this regard.

scholarly journals Effects of the use of preoperative GnRHa analogue and intra-operative mechanical tourniquet for myomectomy on surgical blood loss: A randomised controlled trial

2021 ◽  
Author(s):  
Salwa Abdullahi Idle ◽  
Helen Coles ◽  
Salma Ayis ◽  
Nitish Narvekar
Keyword(s):  
Randomised Controlled Trial ◽  
Blood Loss ◽  
Controlled Trial ◽  
Gnrh Analogue ◽  
Intraoperative Blood Loss ◽  
Operative Blood Loss ◽  
Releasing Hormone ◽  
Significant Difference ◽  
Gonadotrophin Releasing Hormone ◽  
Randomised Controlled

Objective To compare the pre-operative use of GnRH analogue and/or intra-operative use of tourniquets to determine which intervention best reduces the intraoperative blood loss at open myomectomy. Design Randomised controlled trial, partially blinded (clinician and participant) Setting Single tertiary centre Population Women requiring open myomectomy in our gynaecology outpatient clinic Methods Patients were allocated to receive either pre-operative GnRHa, intra-operative mechanical tourniquet or a combination of preoperative GnRHa and intra-operative mechanical tourniquet. Main Outcome Measure Mean intraoperative blood loss Results There was a difference in mean intra-operative blood loss of groups GnRHa (n=14) versus Tourniquet (n=12) (752ml, 95% CI 148ml-1355ml, p=0.01) and groups GnRHa versus GnRHa+ Tourniquet (n=17) (804ml, 95% CI 250ml-1357ml, p=0.002). No significant difference in intra-operative blood loss between groups Tourniquet and GnRHa+ Tourniquet (52ml, 95% CI -630ml-526ml, p=1) were detected. A sub-analysis showed that there is no statistical significance (p=0.45) between mean blood loss at surgery and uterine size across the groups. Conclusions The use of a mechanical tourniquet with or without pre-operative gonadotrophin releasing hormone analogues is significantly more effective at reducing intraoperative blood loss at open myomectomy than the use of pre-operative gonadotrophin releasing hormone analogues alone Tweetable Abstract Mechanical tourniquet with or without GnRHa significantly reduces intraoperative blood loss at open myomectomy EudraCT Number 2010-019810-26

scholarly journals Cell salvage and donor blood transfusion during cesarean section: A pragmatic, multicentre randomised controlled trial (SALVO)

PLoS Medicine ◽  
2017 ◽  
Vol 14 (12) ◽  
pp. e1002471 ◽  
Author(s):  
Khalid S. Khan ◽  
Philip A. S. Moore ◽  
Matthew J. Wilson ◽  
Richard Hooper ◽  
Shubha Allard ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Blood Transfusion ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Cell Salvage ◽  
Donor Blood ◽  
Randomised Controlled
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