Use of intravenous Premarin to decrease postoperative blood loss after pediatric scoliosis surgery.
STUDY DESIGN: The hemostatic effect of conjugated estrogens (Premarin, Wyeth-Ayerst Laboratories, Philadelphia, PA) has been reported in the literature, but no study has investigated its effectiveness in decreasing blood loss in pediatric spinal procedures. OBJECTIVE: To determine the effectiveness of intravenously administered Premarin in the immediate postoperative period in decreasing Hemovac drainage postoperatively. METHODS: Sixty-four adolescent patients undergoing spinal surgery, both posterior and anterior/posterior procedures, were studied. Thirty-two patients served as control subjects. The other 32 received Premarin, 1 mg/kg intravenously in the immediate postoperative period. Hemovac drainage was measured during a period of 48 hours. RESULTS: In measuring Hemovac drainage for 48 hours in both groups, there was a 37% decrease in the volume of the postoperative drainage (mL/kg) in the patients receiving Premarin postoperatively. Measurement of adjusted volumes (mL/kg) revealed a statistically significant decrease in postoperative bleeding after administration of Premarin. CONCLUSIONS: Administration of Premarin resulted in a 37% decrease in the volume of postoperative drainage (mL/kg) without complications. Premarin appears to be effective in decreasing postoperative blood loss in a pediatric postoperative spinal population.