During total hip arthroplasty, replacement of a substantial amount of blood loss is necessary. The adverse effects of homologous blood transfusion have been documented consequently and the intraaperative autotransfusion has attracted considerable interest. The authors have attempted to reduce the amount of the homologous blood transfusion by inducing hypotension and autotransfusion.

Twenty patients who underwent revision total hip arthroplasty were divided into two groups. Group1 received homologous blood perioperatively. Group2 was transfused with predonated autologous blood and intraoperative salvage technique with Cell Saver apparatus, were used along with sodium nitroprusside for hypotensive anesthesia to decrease intraoperative bleeding. We observed the amount of blood loss and transfused blood, and hematologic laboratory data, and complications.

The mean requirement for transfusion was 3080 ml in group1 and 1289 ml in group2. In the level of the hematocrit, there was a significant smaller hematocrit drop (8%) over the first two postoperative days in group2I. There were no complications such as disseminated intravascular coagulopathy, severe thrombocytopenia, microemboli, and nephrotoxicity.

The autologous transfusion and induced hypotension in the total hip arthroplasty is thought to be an effective method to reduce the amount of homologous blood transfusion.