The main aim of the study is evaluating the effect of prophylactic fibrinogen injection on intraoperative bleeding in PSF surgeries comparing to control group. Study population: All patients candidate for PSF surgery between 18 to 60 years old and needed sample size is 42.
Method: After inclusion in the study, one gram fibrinogen would be infused preoperatively. Amount of bleeding during the operation, level of serum fibrinogen before and after surgery and the number of blood bags infused during the surgery would be measured and compared to the control group.
inclusion criteria: ASA I,II patients candidate for elective posterior spine fusion surgery, age 18-60y, BMI less than 30 kg/m2, duration of surgery between 1-4 h,
Exclusion criteria: history of previous PSF, pulmonary, cardiac, hepatic, renal or coagulation disorders, hypertension; beta blocker, calcium blocker, digoxine, TCAs, Anticoagulant and clonidin consumption by patient, alcohol or drug abuse, existing tumor in the site of surgery, surgery in more than 3 levels. The main intervention is fibrinogen infusion before spine surgery. The patients will be divided to fibrinogen and placebo groups,using a computerized random number table. The outcomes are measuring rate of bleeding during operation, hemoglobin and serum fibrinogen level changes before and after surgery and the number of transfused blood to patients and comparing to control group. Patients and the person responsible for measuring the amount of bleeding will be unaware about type of intervention.