Do low molecular weight heparin and dextran increase the blood loss in transurethral resection of the prostate?

Objective To evaluate whether the use of dextran or the combination of low molecular weight heparin and dextran increases the blood loss in elective transurethral resection for benign prostatic hyperplasia. Patients and methods This open randomized controlled study included 198 patients operated under spinal anaesthesia who were allocated to four groups differing in the combination of prophylactic treatment used for thrombosis and for the substitution of blood loss. The prophylactic treatment was either dalteparin sodium, continued each day until mobilization, or 3% Ringer dextran-60 just before operation and continued with 6% dextran-70 for 2 days post-operatively, and the volume substitute was Ringer dextran or Ringer's acetate. Thus, the four treatments (by prophylaxis and volume substitute, respectively) were dalteparin and Ringer's acetate, dalteparin and dextran, dextran and Ringer's acetate, and dextran and dextran. The haemoglobin lost to the irrigation fluid was measured and used to calculate blood loss. Results Patients receiving dextran had a larger postoperative and total blood loss than those who did not. The need for transfusion did not differ between the treatment groups. Conclusion The combination of dalteparin and dextran was not associated with an increased blood loss above that with dextran alone.