[Low-dose aspirin doesn't increase surgical bleeding nor transfusion rate in total knee arthroplasty]. / El tratamiento preoperatorio con aspirina a dosis bajas no aumenta la hemorragia quirúrgica ni la tasa transfusional en la prótesis total de rodilla.

OBJECTIVES: Surgical bleeding. transfusion rate and cardiovascular complications were analized in patients undergoing chronic treatment with low-doses aspirin and scheduled to unilateral primary knee arthroplasty. PATIENTS AND METHODS: We retrospectively studied 117 patients between 2005 and 2006 scheduled for elective knee replacement that received antiplatelet therapy with aspirin (100mg/day). Aspirin medication was maintained or discontinued preoperatively according to medical criteria. We analyzed the biological, clinical and anesthetic data, blood-saving techniques used, surgical bleeding, allogeneic blood transfusion rate, cardiocirculatory complications (myocardial, cerebral or peripheral ischemia), hospital stay and mortality. This population was compared with 190 patients (control group) who underwent the same operation at the same time interval but did not receive aspirin therapy. RESULTS: The aspirin-treated group was significantly older, with higher weight and poorer health state (higher incidence of ischemic heart disease, cerebral ischemia and diabetes). The hidden and external surgical bleeding and transfusion rate were similar if the aspirin were interrupted or not, preoperatively. Bleeding and transfusion rates were independent of time of interruption of the aspirin. Hospital mortality was zero in the 2 groups. A acute myocardial infarction and a transient stroke happened in two patients wich aspirin treatment was discontinued. CONCLUSIONS: Preoperative treatment with low doses of aspirin does not increase surgical bleeding and transfusion rate in total knee arthroplasty. Preoperative discontinuation can cause severe cardiocirculatory complications.

El tratamiento preoperatorio con aspirina a dosis bajas no aumenta la hemorragia quirúrgica ni la tasa transfusional en la prótesis total de rodilla / Low-doses aspirin doesn’t increase surgical bleedind nor transfusion rate in total knee arthroplasty

Objetivos. Analizar la hemorragia quirúrgica, índice transfusional y complicaciones cardiovasculares en pacientes en tratamiento crónico con aspirina y sometidos a artroplastia total primaria unilateral de rodilla. Pacientes y métodos. Se estudió retrospectivamente a 117 pacientes programados entre 2005 y 2006 para cirugía electiva de artroplastia de rodilla y en tratamiento preoperatorio con aspirina (100mg/día). La medicación fue mantenida o interrumpida preoperatoriamente a criterio médico. Se analizaron las características biológicas, clínicas, anestésicas, técnicas de ahorro de sangre, hemorragia quirúrgica, transfusión alogénica, complicaciones cardiocirculatorias (isquemia miocárdica, cerebral o periférica), estancia y mortalidad hospitalarias. Se compararon con 190 pacientes (grupo control) intervenidos de la misma operación en el mismo intervalo de tiempo, pero sin tratamiento crónico con aspirina. Resultados. El grupo tratado con aspirina era significativamente de mayor edad, peso y con más enfermedades asociadas (mayor incidencia de cardiopatía isquémica, isquemia cerebral y diabetes). La hemorragia quirúrgica externa, oculta y total fue similar en ambos grupos, así como la transfusión alogénica. La hemorragia y tasa transfusional fueron independientes del tiempo de interrupción de la aspirina. La mortalidad hospitalaria fue nula en los 2 grupos. Dos pacientes en los que se interrumpió el tratamiento tuvieron un infarto agudo de miocardio y un accidente vascular cerebral transitorio, respectivamente. Conclusiones. El tratamiento preoperatorio con aspirina no incrementa la hemorragia quirúrgica ni el índice transfusional en la artroplastia total de rodilla. La interrupción preoperatoria puede ocasionar complicaciones cardiocirculatorias graves(AU)

Objectives. Surgical bleeding. transfusion rate and cardiovascular complications were analized in patients undergoing chronic treatment with low-doses aspirin and scheduled to unilateral primary knee arthroplasty. Patients and methods. We retrospectively studied 117 patients between 2005 and 2006 scheduled for elective knee replacement that received antiplatelet therapy with aspirin (100mg/day). Aspirin medication was maintained or discontinued preoperatively according to medical criteria. We analyzed the biological, clinical and anesthetic data, blood-saving techniques used, surgical bleeding, allogeneic blood transfusion rate, cardiocirculatory complications (myocardial, cerebral or peripheral ischemia), hospital stay and mortality. This population was compared with 190 patients (control group) who underwent the same operation at the same time interval but did not receive aspirin therapy. Results. The aspirin-treated group was significantly older, with higher weight and poorer health state (higher incidence of ischemic heart disease, cerebral ischemia and diabetes). The hidden and external surgical bleeding and transfusion rate were similar if the aspirin were interrupted or not, preoperatively. Bleeding and transfusion rates were independent of time of interruption of the aspirin. Hospital mortality was zero in the 2 groups. A acute myocardial infarction and a transient stroke happened in two patients wich aspirin treatment was discontinued. Conclusions. Preoperative treatment with low doses of aspirin does not increase surgical bleeding and transfusion rate in total knee arthroplasty. Preoperative discontinuation can cause severe cardiocirculatory complications(AU)

Sensibilidad y especificidad de las pruebas "in vitro" en las reacciones alérgica al altes / Sensitivity and specificity of "in vitro" test for latex allergy

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