Spine Surgery and Major Blood Loss: How Accurate is Suction Canister Estimation?

Purpose of the Study: This study aimed to estimate the proportion of intraoperative blood loss absorbed by gauze during major spine surgeries and identify factors influencing blood loss. Patients and Methods: A prospective cohort study of 28 patients undergoing elective major spine surgery with blood loss exceeding 1 liter was conducted. Blood loss was estimated using the gravimetric method for gauze and measurement of suction canister contents. Demographic and surgical data were collected. Results: On average, 21.19% of total blood loss was absorbed by surgical gauze. When considering blood loss in the suction canister, an additional 28.33% was absorbed by gauze. Two-column surgeries and longer surgical durations were associated with significantly higher total blood loss and suction-collected blood. No statistically significant differences were observed in the percentage of blood loss absorbed by gauze across most demographic and clinical factors. Conclusions: This study provides insights into intraoperative blood loss distribution during major spine surgeries. Surgeons and anesthesiologists should add approximately 28% to the blood loss measured in the suction canister for a more accurate assessment. The findings can guide clinicians in anticipating blood loss and improving transfusion management, potentially leading to better patient outcomes.