Document Type : RESEARCH PAPER
Department of anesthesiology, Shahid Beheshti University of Medical Science, Tehran, Iran
Department of Orthopedics, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Objectives: Excessive blood loss is a critical complication of total hip arthroplasty. We intended to
determine whether preoperative fibrinogen administration reduces perioperative bleeding and the need
for blood transfusion in total hip arthroplasty surgery.
Methods: In 4 months, 178 patients who underwent total hip arthroplasty were randomly assigned equally to
intervention and placebo-control groups in a double-blinded, parallel two-arm randomized controlled trial. Both
intravenously, 30 min before the start of the surgery, the intervention group received two grams of fibrinogen
concentrate dissolved in 100 ml of distilled water. In contrast, the control group received 100 ml of normal saline
solution. The amount of postoperative blood loss served as the main result, and the requirement for blood
transfusions served as the secondary outcome.
Results: In comparison to the placebo, administering fibrinogen concentrate considerably reduced the amount of
blood loss (P=0.001) and the requirement for blood transfusions (P=0.004). Patients who got fibrinogen concentrate
experienced no side effects. In addition, patients in the fibrinogen group had significantly lower hemoglobin and
higher fibrinogen levels in the recovery room and received lesser blood transfusions (P<0.005) than the placebo
Conclusion: In total hip arthroplasty, fibrinogen concentrate lessens postoperative bleeding and the requirement
for blood transfusions.
Level of evidence: II