scholarly journals Effectiveness of tranexamic acid in reducing blood loss in cervical laminoplasty: A retrospective observational study

2020 ◽  
Vol 27 (2) ◽  
pp. 162-165
Author(s):  
Chi-Hei Ho ◽  
Raymond Nang-Man Wong
Keyword(s):  
Body Mass Index ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Operating Time ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
Cervical Laminoplasty ◽  
Thromboembolic Complications ◽  
Perioperative Blood Loss ◽  
Control Study

Background: Tranexamic acid (TXA) has been proved effective in reducing perioperative blood loss in patients undergoing orthopedic operations. However, given the heterogeneity in the diagnoses and spinal operations, there are only limited studies comparing patients with uniform diagnoses and procedures performed. Methods: A comparative observational control study was performed on 62 patients with cervical myelopathy. They were divided into control (32) and TXA (30) groups according to whether they had received TXA before and during surgery. Cervical laminoplasty from C3 to C6/7 was performed for all patients using a consistent procedure. Preoperative and postoperative hematological data and perioperative blood loss were compared. Results: There were no statistically significant differences between the two groups in terms of age, gender, body mass index, and operating time. The TXA group had significantly less intraoperative (310 ± 215 ml vs. 144 ± 90 ml, p < 0.05) and postoperative blood loss than the control group (150 ± 50 ml vs. 249 ± 94 ml, p < 0.01). The drop of hemoglobin (Hb) level in the TXA group was also significantly lower (0.5 ± 0.42 g/dl vs. 2.1 ± 1.03 g/dl, p < 0.01). No thromboembolic complications found. Conclusion: TXA significantly reduced perioperative blood loss and reduced drop of postoperative Hb level in cervical laminoplasty.

scholarly journals The Safety and Efficacy of Tranexamic Acid in Oncology Patients Undergoing Endoprosthetic Reconstruction and a ROTEM-Based Evaluation of Their Hemostatic Profile: A Pilot Study

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 3951
Author(s):  
Andreas G. Tsantes ◽  
Ioannis G. Trikoupis ◽  
Dimitrios V. Papadopoulos ◽  
Stavros Goumenos ◽  
Daniele Piovani ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Control Group ◽  
Thromboembolic Complications ◽  
Endoprosthetic Reconstruction ◽  
Oncology Patients ◽  
Safety And Efficacy ◽  
Perioperative Blood Loss ◽  
Transfusion Requirements ◽  
Musculoskeletal Oncology

Background: An endoprosthetic reconstruction in musculoskeletal oncology patients is associated with significant blood loss. The purpose of this study is to evaluate the safety and efficacy of tranexamic acid (TXA) for these patients and to assess any changes in their hemostatic profile using rotational thromboelastometry (ROTEM). Methods: A retrospective observational study was performed including 61 patients with primary or metastatic bone tumors who underwent surgery. Group A (n = 30) received both intravenous and local TXA whereas Group B (n = 31) was the control group. The primary outcomes were perioperative blood loss and blood unit transfusions and the secondary outcomes included the incidence of thromboembolic complications and a change in blood coagulability as reflected by ROTEM parameters. Results: The median difference in blood loss between the two groups was 548.5 mL, indicating a 29.2% reduction in the 72 h blood loss following TXA administration (p < 0.001). TXA also led to a reduced transfusion of 1 red blood cell (RBC) unit per patient (p < 0.001). The two groups had similar rates of thromboembolic complications (p = 0.99). The antifibrinolytic properties of TXA were confirmed by the significantly higher INTEM, FIBTEM and EXTEM LI60 (p < 0.001, p = 0.005 and p < 0.001, respectively) values in the TXA group. Conclusion: Tranexamic acid was associated with a significant reduction in perioperative blood loss and transfusion requirements without a complete shutdown of the fibrinolysis. Larger studies are warranted to assess the frequency of these outcomes in musculoskeletal oncology patients.

Tranexamic Acid Effectiveness on the Amount of Bleeding during Surgery and Surgeon’s Satisfaction in Intertrochanteric Fracture Fixation: A Randomized Clinical Trial

2020 ◽  
Author(s):  
Morteza Saeb ◽  
Ali Mousapour ◽  
Alireza Shafiee ◽  
Seyyed Saeed Khabiri ◽  
Roya Safari-Faramani ◽  
...  
Keyword(s):  
Placebo Group ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Intertrochanteric Fracture ◽  
Intervention Group ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
The Mean ◽  
The Difference ◽  
Fracture Surgery

Background: The purpose of this study was to evaluate the effect of intravenous tranexamic acid (TXA) on the blood loss volume during surgery and surgeon's satisfaction in intertrochanteric fracture surgery. Methods: A total of 62 patients with intertrochanteric fracture were involved in the study and accidentally categorized into two groups. In the control or first group, patients were medicated with placebo (age: 69.2 ± 6.1 years old) and in the second group or intervention, they received 1 g injection of TXA (age: 69.7 ± 6.4 years old). Intraoperative bleeding was measured by the amount of blood in the suction bottle and amount of gauze utilized and postoperative blood loss was measured by the amount of blood in the drain 48 hours after surgery. Also, hemoglobin (Hb) levels were compared before and after surgery. In the end, the surgeon’s satisfaction was measured by Likert scale. Results: The difference in the amount of intra-operative bleeding was significant between the groups (P < 0.050). The mean number of utilized gauze in the intervention group was meaningfully less than the placebo group (P < 0.050). The mean Hb in the control group was considerably inferior to the intervention group (P < 0.050). The respect of patients in need of transfusion in the placebo group was outstandingly superior to the intervention group (P < 0.005). Surgeon satisfaction in the intervention group was considerably greater than the control group (P < 0.050). Conclusion: The use of intravenous TXA during intertrochanteric fracture surgery can reduce hemorrhage during surgery, reduce the need for blood products, and finally improve the surgeon’s satisfaction.

scholarly journals High-dose tranexamic acid reduces intraoperative and postoperative blood loss in posterior lumbar interbody fusion

2017 ◽  
Vol 26 (3) ◽  
pp. 363-367 ◽  
Author(s):  
Junichi Kushioka ◽  
Tomoya Yamashita ◽  
Shinya Okuda ◽  
Takafumi Maeno ◽  
Tomiya Matsumoto ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Interbody Fusion ◽  
Surgical Techniques ◽  
Posterior Lumbar Interbody Fusion ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
High Dose ◽  
Lumbar Interbody Fusion ◽  
Single Level

OBJECTIVE Tranexamic acid (TXA), a synthetic antifibrinolytic drug, has been reported to reduce blood loss in orthopedic surgery, but there have been few reports of its use in spine surgery. Previous studies included limitations in terms of different TXA dose regimens, different levels and numbers of fused segments, and different surgical techniques. Therefore, the authors decided to strictly limit TXA dose regimens, surgical techniques, and fused segments in this study. There have been no reports of using TXA for prevention of intraoperative and postoperative blood loss in posterior lumbar interbody fusion (PLIF). The purpose of the study was to evaluate the efficacy of high-dose TXA in reducing blood loss and its safety during single-level PLIF. METHODS The study was a nonrandomized, case-controlled trial. Sixty consecutive patients underwent single-level PLIF at a single institution. The first 30 patients did not receive TXA. The next 30 patients received 2000 mg of intravenous TXA 15 minutes before the skin incision was performed and received the same dose again 16 hours after the surgery. Intra- and postoperative blood loss was compared between the groups. RESULTS There were no statistically significant differences in preoperative parameters of age, sex, body mass index, preoperative diagnosis, or operating time. The TXA group experienced significantly less intraoperative blood loss (mean 253 ml) compared with the control group (mean 415 ml; p < 0.01). The TXA group also had significantly less postoperative blood loss over 40 hours (mean 321 ml) compared with the control group (mean 668 ml; p < 0.01). Total blood loss in the TXA group (mean 574 ml) was significantly lower than in the control group (mean 1080 ml; p < 0.01). From 2 hours to 40 hours, postoperative blood loss in the TXA group was consistently significantly lower. There were no perioperative complications, including thromboembolic events. CONCLUSIONS High-dose TXA significantly reduced both intra- and postoperative blood loss without causing any complications during or after single-level PLIF.

scholarly journals Tranexamic Acid has no Effect on Post-Operative Hemarthrosis or Pain Control Following ACL Reconstruction Using Bone Patella Tendon Bone Autograft: A Double-Blind Randomized Controlled Double-Blind Trial (169)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0029
Author(s):  
Jordan Fried ◽  
David Bloom ◽  
Samuel Baron ◽  
Eoghan Hurley ◽  
Jovan Popovic ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Acl Reconstruction ◽  
Control Group ◽  
Patella Tendon ◽  
Double Blind ◽  
Randomized Controlled ◽  
Perioperative Blood Loss ◽  
Significant Difference ◽  
Experimental Group

Objectives: Tranexamic acid (TXA) is a commonly used medication in orthopaedic procedures, reducing perioperative bleeding and need for transfusion. The purpose of this double-blind randomized controlled study was to evaluate if IV TXA for primary anterior cruciate ligament (ACL) reconstruction with bone-patella tendon-bone (BTB) could reduce perioperative blood loss or postoperative intra-articular hemarthrosis without postoperative drains. Methods: A controlled, randomized, double-blinded trial was conducted in 110 patients who underwent ACLR with BTB autograft. Patients were equally randomized to the control and experimental groups. The experimental group received two 1-gram boluses of IV TXA, one prior to tourniquet inflation and one prior to wound closure; the control group did not receive TXA. If a clinically significant hemarthrosis was evident, the knee was aspirated, and the volume of blood (ml) was recorded. Additionally, perioperative blood loss (ml); Visual Analog Scale (VAS) on postoperative days (POD) 1-7 and post-operative weeks (POW) 1, 6 and 12; postoperative opioid consumption POD 1-7; range of motion (ROM) and ability to straight leg raise (SLR) at POW 1, 6, 12; and pre and postoperative thigh circumference ratio (TCR). Results: There was no significant difference in perioperative blood loss between the experimental and control groups (32.5ml v. 35.6ml, p=0.47). The experimental group had 23 knees aspirated; control group had 26 knees aspirated (p=0.56). No significant difference seen in postoperative hemarthrosis volume with IV TXA (26.7ml v. 37.3ml, p=0.12). There was no significant difference in VAS score between the two groups (p=0.15), additionally, there was no difference in postoperative opioid consumption (p=0.33). There was no significant difference in ROM or ability to SLR, or pre- nor post-operative TCR (p > 0.05 for all). Conclusions: IV TXA in patients who undergo ACLR with BTB autograft does not significantly impact perioperative blood loss, postoperative hemarthrosis, or postoperative pain levels. Additionally, no significant differences were seen in early post-operative recovery regarding ROM or quadriceps reactivation.

scholarly journals 1484 Tranexamic Acid Use to Decrease Blood Loss in Primary Shoulder and Elbow Replacement: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Varma ◽  
R Donovan ◽  
M Whitehouse ◽  
S Kunutsor ◽  
A Blom
Keyword(s):  
Systematic Review ◽  
Blood Transfusion ◽  
Length Of Stay ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Meta Analysis ◽  
Postoperative Blood Loss ◽  
Perioperative Blood Loss ◽  
Transfusion Requirements ◽  
Elbow Replacement

Abstract Tranexamic acid (TXA) is an inexpensive, commonly used antifibrinolytic agent that has been shown to significantly reduce perioperative blood loss and transfusion requirements after total hip and knee replacement. We conducted a systematic review and meta-analysis to synthesise the latest evidence regarding the effects of TXA on blood loss in total shoulder replacement (TSR) and total elbow replacement (TER). We systematically searched MEDLINE, EMBASE and CENTRAL from inception to 03 September 2020 for randomised controlled trial (RCTs) and observational studies. Our primary outcome was blood loss, and secondary outcomes included the need for blood transfusion and venous thromboembolic (VTE) complications. Four RCTs and five retrospective cohort studies (RCS) met eligibility criteria for TSRs, but none for TERs. RCT data determined that TXA administration significantly decreased estimated total blood loss, postoperative blood loss, change in haemoglobin (Hb) and total Hb loss when compared to placebo. RCS data demonstrated significant association between TXA administration and decreased in postoperative blood loss, change in Hb, change in Hct and length of stay. This meta-analysis demonstrates that TXA administration in primary TSR significantly decreases blood loss compared with placebo and is associated with lower blood loss and shorter length of stay compared with no treatment with no increase in VTE complications. TXA administration should be part of a wider blood management strategy to minimise perioperative blood loss and blood transfusion requirements in patients undergoing TSR. Further research is needed to demonstrate if a similar treatment benefit exists in patients undergoing TER.

scholarly journals Effect and safety of topical application of tranexamic acid to reduce perioperative blood loss in elderly patients with intertrochanteric fracture undergoing PFNA 

2020 ◽  
Author(s):  
Huiping Wei ◽  
Qiuping Xiao ◽  
Jianfeng He ◽  
Tianji Huang ◽  
Wantang Xu ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Topical Application ◽  
Control Group ◽  
Specific Method ◽  
Intertrochanteric Fractures ◽  
Perioperative Blood Loss ◽  
Perioperative Bleeding

Abstract Background: The specific method and dose of tranexamic acid (TXA) topically applied for intertrochanteric fractures have not been well established. The aim of this study is to investigate the efficacy and safety of TXA topically administered via our protocol for perioperative bleeding management in elderly patients with intertrochanteric fractures who underwent proximal femoral nail anti-rotation (PFNA).Methods: A retrospective comparative analysis was performed. The TXA group was composed of 82 patients with topical use of TXA, and the control group was composed of 82 patients without TXA use during the PFNA procedure. Intraoperative, total and hidden amounts of blood loss, drainage volumes, postoperative blood transfusion volumes and complications were compared between the two groups.Results: The intraoperative, total and hidden amounts of blood loss and the drainage volumes were significantly lower in the TXA group than in the control group (P=0.012, P<0.01, P<0.01, P=0.014, respectively). The volume and rate of blood transfusion in the TXA group were significantly lower than those in the control group (P<0.01). There were no significant differences in complications between the two groups (P>0.05).Conclusion: Topical application of TXA offers an effective and safe option for reducing perioperative blood loss and transfusion in elderly patients with intertrochanteric fractures undergoing PFNA.

scholarly journals Effect of High Dose Tranexamic Acid and Etamsylate in Reducing Blood Loss during Trans-Urethral Resection of Prostate, Bladder Tumours and Percutaneous Nephrolithotomy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Safan ◽  
M Samir ◽  
A M Saeed ◽  
A S I Farag
Keyword(s):  
Side Effects ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Vital Role ◽  
Control Group ◽  
High Dose ◽  
University Hospitals ◽  
Dose Combination ◽  
Group 2 ◽  
Control Study

Abstract Background Bleeding is one of the most serious events that can occur intra-operative as well as post-operative in TURP, TURBT, PCNL and minimizing blood loss is of vital role in preventing or reducing morbidity and mortality following these procedures. Aim of the Work The aim of the present study was to to evaluate the efficacy of high dose tranexamic acid and etamsylate in reducing blood Loss during TURP, PCNL, TURBT and to determine if we can use them as a routine or not. Patient and Methods The study, was a prospective randomized control study, would be conducted on 70 patients admitted through the outpatient urology clinic in Ain shams University Hospitals and Nasser institute hospital. The 70 patients were divided into two main groups. Each one was 35 patients, each group is subdivided into 3 subgroups ((a)TURP,(b)PCNL AND (c)TURBT). Group 1 (all did not receive the combination of high dose tranexamic acid and ethamsylate) Group 2 (all received the combination of high dose tranexamic acid 2g per day and ethamsylate2.5g per day). Results We found that hemoglobin and hematocrit drop was significantly smaller in cases group and subgroups compared with the control group and subgroups, we also found that blood transfusion is reduced in control group and subgroups than in cases. Also procedure time was highly significant decreased in cases compared with controls. the high dose combination tranexamic acid 2g per day and ethamsylate2.5g per day was found to be safe without side effects especially thromboembolic side effects. Conclusion The study showed that High dose tranexamic acid and etamsylate is safe and effective in reducing blood loss during TURP,PCNL and TURBT. but we still cannot use them as a routine in all patients because our study is conducted on patients with selected criteria so further studies are needed.

scholarly journals Topical tranexamic acid in hip fractures: a randomized, placebo-controlled double-blinded study

2021 ◽  
Vol 64 (4) ◽  
pp. E449-E456
Author(s):  
Darren Costain ◽  
Graham Elder ◽  
Brian Fraser ◽  
Brad Slagel ◽  
Adrienne Kelly ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Troponin I ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
Hip Fracture Surgery ◽  
Coronary Syndrome ◽  
The Difference ◽  
Fracture Surgery

Background: Tranexamic acid (TXA) has been shown to reduce perioperative blood loss in elective orthopedic surgery. The safety of intravenous TXA in nonelective hip fracture surgery is uncertain. The purpose of this study was to evaluate the efficacy and safety of topical TXA in hip fracture surgery. Methods: Adult patients presenting to a community hospital with a hip fracture requiring surgery were randomly assigned to receive topical TXA or placebo. Hemoglobin and troponin I levels were measured preoperatively and on postoperative days 1, 2 and 3. All postoperative blood transfusions were recorded. Complications, including acute coronary syndrome (ACS), venous thromboembolism (VTE), cerebrovascular accidents (CVA), surgical site infections (SSI) and 90-day mortality, were recorded. Results: Data were analyzed for 65 patients (31 in the TXA group, 34 in the control group). Hemogloblin level was significantly higher on postoperative days 1 and 2 in the TXA group than in the control group. The difference in hemoglobin level between the groups was not statistically significant by postoperative day 3. Significantly fewer units of packed red blood cells were transfused in the TXA group (2 units v. 8 units); however, 2 of the units in the control group were given intraoperatively, and when these were excluded the difference was not significant. The incidence of ACS, CVA, VTE, SSI, transfusion and all-cause mortality at 90 days did not differ significantly between the groups. Conclusion: Topical TXA reduces early postoperative blood loss after hip fracture surgery without increased patient risk. Trial registration: Clinicaltrials.gov, no. NCT02993341.

scholarly journals Is There a Role for Preoperative Local Infiltration of Tranexamic Acid in Elective Spine Surgery? A Prospective Randomized Controlled Trial Analyzing the Efficacy of Intravenous, Local Infiltration, and Topical Administration of Tranexamic Acid

2019 ◽  
Vol 11 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Viswanadha Arun-Kumar ◽  
J. Naresh-Babu
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Spine Surgery ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Local Infiltration ◽  
Safety And Efficacy ◽  
Instrumented Spine Surgery

Study Design: Randomized control trial. Objective: The purpose of the study is to evaluate the safety and efficacy of tranexamic acid in reducing blood loss when administered through various routes in instrumented spine surgeries. Methods: A total of 104 patients undergoing instrumented spine surgery were randomly assigned to 4 groups (n = 26 in each group). Groups included (1) ivTXA—intravenous administration of tranexamic acid (TXA) 1 hour prior to surgery, (2) loTXA—local infiltration of TXA bilaterally into the paraspinal musculature prior to incision, (3) tTXA—topical application of TXA just before wound closure, and (4) control group. Outcome measures included intraoperative blood loss, postoperative blood loss, need for blood transfusion, length of hospital stay, and hematological parameters. Results: All the 3 different modes of TXA administration were found to be effective in reducing blood loss in the treated groups compared with the control group. Intraoperative blood loss was significantly reduced in ivTXA (223.6 ± 40.1 mL, P < .0001) and loTXA (256.07 ± 119 mL, P = .0039) groups when compared with controls (344 ± 88.5 mL).The postoperative blood loss was least in tTXA followed by ivTXA, loTXA, and controls. There was 67% reduction in need for blood transfusion in tTXA group, 55.5% reduction in ivTXA group, and 33% reduction in loTXA group when compared with the control group. Conclusion: In instrumented spine surgery, ivTXA and loTXA were found to be equally effective in reducing the intraoperative blood loss. The tTXA has better postoperative blood conserving effects. This is the first study to detail about safety and efficacy on local infiltration of TXA in spine surgery, which is an effective and safe method for reducing intraoperative blood loss.

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