ascorbic-acid and Blood-Loss--Surgical

Most interventions aimed at reducing bleeding during myomectomy lack sufficient evidence regarding their effectiveness. Recently, it was reported that intraoperative ascorbic acid administration effectively reduced blood loss during abdominal myomectomy. Therefore, this study aimed to investigate whether intravenous ascorbic acid infusion would affect intraoperative blood loss in women undergoing laparoscopic myomectomy.. A randomized, double-blind, parallel-group, placebo-controlled trial including 50 women undergoing laparoscopic myomectomy was conducted. Women with ≤4 myomas, ≤9cm in maximum diameter were eligible. The study:control group ratio was 1:1. Starting 30minutes before anesthesia, 2g of ascorbic acid or a placebo were administered for 2hours intraoperatively. Intraoperative blood loss, the primary endpoint, was calculated as the difference between the volume of fluids acquired from suction and that used for irrigation of the abdominal cavity during surgery using constant values.. Among the 50 randomized women, 1 and 3 in the study and control groups, respectively, were excluded due to withdrawal of consent, cancelation of surgery, or non-measurement of the primary endpoint. The baseline and operative characteristics were similar between the study and control groups, as was the intraoperative blood loss (193±204mL vs. 159±193mL, P=0.52). In addition, the operating time (95±29min vs. 110±52min; P=0.50) and decrease in hemoglobin level after surgery (1.9±1.31g/dL vs. 1.4±1.4g/dL; P=0.24) were similar between the study and control groups.. Intravenous ascorbic acid infusion did not reduce intraoperative blood loss in women undergoing laparoscopic myomectomy.. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01715597.

Topics: Adult; Ascorbic Acid; Blood Loss, Surgical; Double-Blind Method; Female; Humans; Infusions, Intravenous; Leiomyoma; Middle Aged; Operative Time; Treatment Outcome; Uterine Myomectomy; Uterine Neoplasms

To assess the usefulness of using ascorbic acid (vitamin C) administration in abdominal myomectomy.. A total of 102 patients were divided two groups in this prospective, clinical trial. Group A had received 2 g of ascorbic acid during a myomectomy, and group B had a myomectomy without any interventions. The operative time, blood loss, days of hospitalization, post-operative complications and rate of blood transfusions were compared between the two groups.. The blood loss (521.44 ± 199.24 vs. 932.9 ± 264.38 ml; p value <0.001), duration of the operation time (42 ± 13.9 vs. 68 ± 21.7 min; p value <0.001), days of hospitalization (2.7 ± 0.69 vs. 3.1 ± 0.59 days; p value 0.002) in group A were significantly less than in group B (p value 0.001). The chance risk ratio of a blood transfusion in group A was 0.4 (7.7 vs. 18% 95% CI of 0.1-1; p value 0.07). There was a significant correlation between the volume of bleeding and post-operative complications in both groups (p value in group A = 0.03; in group B = 0.004).. The administration of ascorbic acid (vitamin C) in abdominal myomectomy could reduce the blood loss during the procedure, operation time and days of hospitalization.

Topics: Adult; Antioxidants; Ascorbic Acid; Blood Loss, Surgical; Blood Transfusion; Female; Gynecologic Surgical Procedures; Hospitalization; Humans; Infusions, Intravenous; Leiomyoma; Postoperative Complications; Uterine Neoplasms

Preoperative anaemia is a major risk factor for allogeneic blood transfusion (ABT) in patients undergoing hip fracture repair. We investigated the efficacy of preoperative recombinant human erythropoietin (rHuEPO) administration for reducing ABT requirements in a series of consecutive hip fracture patients presenting with haemoglobin (Hb) between 10 g/dl and 13 g/dl.. The blood conservation protocol consisted of the application of a restrictive transfusion trigger (Hb < 8 g/dl) and the perioperative administration of intravenous iron sucrose (3 x 200 mg/48 h) (group 1, n = 115). Additionally, some patients received preoperative rHuEPO (40 000 IU sc) on admission to the orthopaedic ward (group 2, n = 81).. Overall, 103 of 196 patients (52.5%) received at least one ABT unit (2.1 +/- 1.0 U/patient). However, there were significant differences in perioperative ABT rates between groups (60% vs. 42%, for groups 1 and 2, respectively; P = 0.013). Postoperative Hb on postoperative days 7 and 30 was higher in group 2 than in group 1. In addition, in group 2, Hb levels were higher on postoperative day 30 than on admission (12.7 +/- 1.0 g/dl vs. 11.9 +/- 0.8 g/dl, respectively; P = 0.030). Administration of rHuEPO did not increase postoperative complications or 30-day mortality rate. Only three mild intravenous iron adverse effects were witnessed.. In anaemic hip fracture patients managed with perioperative intravenous iron and restrictive transfusion protocol, preoperative administration of rHuEPO is associated with reduced ABT requirements. However, appropriate training, education and awareness are needed to avoid protocol violations and to limit further exposure to ABT and ABT-related risks.

Topics: Aged; Aged, 80 and over; Ascorbic Acid; Blood Loss, Surgical; Blood Transfusion; Epoetin Alfa; Erythropoietin; Female; Ferric Compounds; Ferric Oxide, Saccharated; Folic Acid; Fracture Fixation, Internal; Glucaric Acid; Guideline Adherence; Hip Fractures; Hospitals, University; Humans; Male; Postoperative Complications; Premedication; Prospective Studies; Recombinant Proteins; Retrospective Studies; Vitamin B 12