The Journal of Bone and Joint Surgery, Vol 68, Issue 3 350-353, Copyright © 1986 by Journal of Bone and Joint Surgery, Inc
Total hip arthroplasty in Jehovah's Witnesses without blood transfusion
CL Nelson and WS Bowen
One hundred patients who were Jehovah's Witnesses underwent total hip
replacement without transfusion, of which eighty-nine procedures were
performed under hypotensive anesthesia. Of these eighty-nine patients,
sixty-five had not had previous hip surgery and sustained an average
intraoperative blood loss of 450 milliliters. This was a 43 per cent
reduction in blood loss as compared with a control group of patients, who
were not Jehovah's Witnesses and who had total hip replacement under
normotensive anesthesia. Twenty-four of the eighty-nine patients who were
Jehovah's Witnesses and had had previous hip surgery underwent total hip
arthroplasty under hypotensive anesthesia and sustained an average
intraoperative blood loss of 680 milliliters, which was 30 per cent less
than that of similar matched controls who were operated on under
normotensive anesthesia. The postoperative blood loss in the patients who
had had hypotensive anesthesia was not increased compared with that in the
controls. Eleven Jehovah's Witnesses who were not candidates for
hypotensive anesthesia had a total hip replacement under normotensive
techniques. Factors other than hypotensive anesthesia that aided in
reducing blood loss were careful surgical technique, meticulous hemostasis,
and well planned surgery. There were six complications, one of which was
possibly related to hypotensive anesthesia, and no deaths.
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