ABSTRACT

Aim: The purpose of this study was To know any alteration in plasma antithrombin III concentration during postoperative period of major orthopedic surgery.

Place and duration of study: In hematology section of pathology department at postgraduate medical institute (PGMI), Lahore from 1^stFebruary2014 to31^stJanuary 2015.

Study design: It was an observational study.

Methods: After visiting orthopedic ward of Services Institute of Medical Sciences (SIMS) Lahore, forty patients were selected for this study who were planned and enlisted for major orthopedic surgery. Out of forty patients, twenty were of male gender and remaining twenty of female gender, having mean age of 48.6 years. Ten healthy subjects were selected to constitute control group after a proper matching in respect to age and sex of subjects in patient group. Two anticoagulated venous blood samples were drawn from each patient. First sample 24 hours prior to surgery and second 72 hours after surgery. A single blood sample was drawn from control subjects.

Results: It was observed at the completion of this study that almost in all patients there was a remarkable fall in concentration of plasma antithrombin III (AT III) after major orthopedic surgery. This critically noteworthy fallof29.3% in AT III levels might be the outcome of potent systemic activation of all clotting factors as a result of local vascular trauma inflicted during surgical procedure, local vascular stasis, massive trauma to tissues and release of tissue thromboplastin during surgery.

Conclusion: There was a significant decrease in plasma level of antithrombin III during postoperative period of major orthopedic surgery, an observation usually not appreciated in general surgery patients.

Keywords: Preoperative blood sample, Major Orthopedic surgery, AT III.