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How accurate is visual estimation of perioperative blood loss in adolescent idiopathic scoliosis surgery?

ABSTRACT: OBJECTIVE:The aim of this study was to assess whether the visual estimation method for perioperative blood loss is accurate in adolescent idiopathic scoliosis surgery. METHODS:Sixty-five consecutive patients, who were operated on from 2012 to 2015 and had a diagnosis of AIS, were included into the study. Gender, age, preoperative weight and height, preoperative major curve magnitude and T5?T12 kyphosis angles, the fusion level, and the time of surgery were recorded. Perioperative blood loss was estimated by the same anesthesiologist for all patients. Then, an experienced surgeon estimated the perioperative blood loss by a gravimetric method, and the results were compared. RESULTS:Seventeen (26.2%) of the patients were male and 48 (73.8%) were female. The mean age was 15.8 ± 1.9. The mean height of the patients was 162.1 ± 8.9 cm and the mean weight was 52.6 ± 8.9 kg. The mean preoperative major curve magnitude and kyphosis angles were 49.5 ± 9.2 and 47.1 ± 12.7 respectively. The mean estimate of the surgeon was 1009 ± 404.5 ml and the mean estimate of the anesthesiologist was 434 ± 217.6 ml and the difference was statistically significant (p < 0.05). Moreover, if blood loss was high during the operation, the difference between the estimates of the surgeon and anesthesiologist was also higher. CONCLUSIONS:Even in operations where most of the blood goes into a suction canister, such as for AIS, a visual estimation method is not accurate. A short training regarding optimizing the amount of blood contained in sponges that are not fully soaked may be sufficient to improve this method.

SUBMITTER: Ulusoy A

PROVIDER: S-EPMC6146011 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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How accurate is visual estimation of perioperative blood loss in adolescent idiopathic scoliosis surgery?

Ulusoy Ayhan A Demiroz Serdar S Erdem Sevki S

Acta orthopaedica et traumatologica turcica 20180426 4

<h4>Objective</h4>The aim of this study was to assess whether the visual estimation method for perioperative blood loss is accurate in adolescent idiopathic scoliosis surgery.<h4>Methods</h4>Sixty-five consecutive patients, who were operated on from 2012 to 2015 and had a diagnosis of AIS, were included into the study. Gender, age, preoperative weight and height, preoperative major curve magnitude and T5‒T12 kyphosis angles, the fusion level, and the time of surgery were recorded. Perioperative ...[more]

PMID: 29705298

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Project description:Chronic postsurgical pain (CPSP) affects half a million children annually in the United States, with dire socioeconomic consequences, including long-term disability into adulthood. The few studies of CPSP in children are limited by sample size, follow-up duration, non-homogeneity of surgical procedure and factors evaluated.In a prospective study of 144 adolescents undergoing a single major surgery (spine fusion), we evaluated demographic, perioperative, surgical and psychosocial factors as predictors of a continuum of postsurgical pain: immediate, pain maintenance at 2-3 months (chronic pain/CP) and persistence of pain a year (persistent pain/PP) after surgery.We found an incidence of 37.8% and 41.8% for CP and PP. CP and acute pain were both significant predictors for developing PP (p-value <0.001 and 0.003). Preoperative pain and higher postoperative opioid requirement was significantly associated with CP (p = 0.015, p = 0.002), while Childhood Anxiety Sensitivity Index (p = 0.002) and surgical duration (p = 0.014) predicted PP. The final regression models had reasonable predictive accuracy (c-statistic of 0.73 and 0.83 for CP and PP, respectively). Anxiety scores and catastrophizing for child and parent were found to be significantly correlated (p = 0.005, p = 0.013 respectively). Pain trajectories revealed that 65% of patients who developed PP reported CP and high pain trends; however, 33% of those who developed PP could not be identified using solely pain criteria.Persistent postsurgical pain in children is a significant problem. It can be predicted in part by combinations of psychological and clinical variables, which may provide evidence-based measures to prevent development of CPSP in the future.In a homogeneous cohort of adolescents undergoing spine fusion, we report a high incidence of persistent postsurgical pain (41.8%) predicted by child anxiety, perioperative pain, and surgical duration. Our results stress timely preventive and therapeutic strategies.

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How accurate is visual estimation of perioperative blood loss in adolescent idiopathic scoliosis surgery?

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How accurate is visual estimation of perioperative blood loss in adolescent idiopathic scoliosis surgery?

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