The Journal of Bone and Joint Surgery, Vol 76, Issue 10 1545-1550, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
The hemostatic effects of desmopressin on patients who had total joint arthroplasty. A double-blind randomized trial
TA Karnezis, SD Stulberg, RL Wixson and P Reilly
Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois 60611-3008.
The effects of desmopressin on postoperative bleeding and postoperative
transfusion requirements were studied in ninety-two hemostatically normal
patients who had had an elective primary total hip or total knee
arthroplasty. The patients were randomized into either a placebo or a
desmopressin group in a double-blind prospective clinical trial. During
closure of the wound, desmopressin (0.03 microgram per kilogram of body
mass) or the placebo was infused into a peripheral vein over a
twenty-minute period. Compared with the placebo, desmopressin did not
significantly decrease blood loss or transfusion requirements, and it did
not affect the postoperative platelet or fibrinogen levels or the bleeding
time. The results were no different even when the treatment and control
groups were matched according to surgeon, use of cement for the femoral and
knee components, preoperative use of non-steroidal anti-inflammatory
agents, or performance of a lateral release for total knee arthroplasty. We
concluded that desmopressin does not reduce blood loss or transfusion
requirements after total joint arthroplasty.
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