scholarly journals Efficacy and safety of pre-operative single dose parenteral tranexamic acid in moderately anaemic parturients undergoing caesarean section

2017 ◽  
Vol 6 (8) ◽  
pp. 3423
Author(s):  
Robin Medhi ◽  
Sonika Bawri ◽  
Chaitra S.K. ◽  
Mansur Ahmed ◽  
Asmita Mishra
Keyword(s):  
Caesarean Section ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Total Blood ◽  
Moderate Anaemia

Background: Preoperative administration of Tranexamic acid (TXA) has been found to be effective in reducing the amount of blood loss following Caesarean section in low risk women. However, studies in high risk women such as women with anaemia, where blood loss needs to be minimised are scarce.Methods: An experimental case control study was conducted with a total of 174 patients with moderate anaemia undergoing CS in a teaching hospital. Study group consisting of 87 patients received pre-operative TXA 1g intravenously. Intra operative and up to 6hours postpartum blood loss was calculated in both the groups. Requirement of blood transfusions were noted. Data analysed using Graphpad Instat® 3 statistical software.Results: Present study showed statistically significant reduction in intraoperative and postoperative blood loss among patients who received TXA compared to control group. The blood loss from placental delivery till completion of the procedure was significantly lowered (304.02ml vs 393.36ml; p value <0.0001). Postoperative blood loss (from end of the procedure up to 6hrs postpartum) was 62.57ml in comparison to 85.40ml in control group (p value <0.0001). The total blood loss from the placental delivery up to 6 hours postpartum was significantly reduced in study group (366.59ml vs 478.76ml; p value <0.0001). There was significant reduction of blood transfusion in study group (RR: 0.20, 95% CI, 0.045-0.887), without immediate adverse effect on mothers and new-borns.Conclusions: Administration of TXA preoperatively causes significant decrease in blood loss and the need for blood transfusion in patients with moderate anaemia undergoing CS. 

scholarly journals Comparison of Blood Loss using Intra-Articular Injection of Tranexamic Acid after Total Knee Replacement

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Aziz Sabbir Husain
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Transfusion Rate ◽  
Total Knee

Introduction:  Total knee replacement (TKR) is one of the most common surgeries in orthopedic field. Up to 1/3 of the patients require blood transfusion postoperative. Allogenic transfusion has many side effects. Tranexamic acid (TXA) is a synthetic antifibrinolytic agent. We explore the usage of TXA in reducing blood loss and transfusion rate by injecting it into the knee joint during surgery.  Materials and method: This is a retrospective study done in Hospital Tengku Ampuan Rahimah, Klang. Medical records of patient undergoing TKR between 1 January 2018 till 31 December 2018 were reviewed. Study sample was calculated as 90 patients and divided into 2 groups, one receiving TXA (study) and the other not receiving TXA (control). Post-operative hemoglobin levels and transfusion rate was recorded.  Results: 45 patients in study group (17 male, 28 female) had a mean age of 65.4 years old and 45 patients in control group (24 male, 21 female) had a mean age of 64.2 years old. Mean post-operative hemoglobin drop in study group was 1.08 g/dL vs 1.86 g/dL in control group. Repeated measure ANOVA determined a p value of 0.001 which shows a significant correlation. Total transfusion rate in study group was 1 vs 9 in the control group. Using chi-square test, the p-value was 0.007 which again shows a statistically significant result.  Conclusion: Intra-articular injection of TXA following TKR reduces blood loss and the need for blood transfusion without increasing any complication. This prevents many patients from undergoing a potentially hazardous blood transfusion. A routine usage of intra-articular TXA in patients undergoing TKR is recommended. However a large and well designed RCT is required to investigate the risk and benefits of TXA.

scholarly journals Study of the efficacy of tranexamic acid in reducing blood loss after child birth

2021 ◽  
Vol 10 (5) ◽  
pp. 1863
Author(s):  
Nagajyothi Gunturu ◽  
D. Shivani ◽  
P. Sravanthi
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Vaginal Delivery ◽  
Active Management ◽  
Control Group ◽  
Study Group ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Third Stage

Background: The aim was to study the efficacy of tranexamic acid in reducing blood loss after childbirth in normal vaginal delivery and LSCS.Methods: 200 pregnant women divided into two groups group 1 and group 2, 100 women undergoing LSCS and 100 women undergoing vaginal delivery. Study group will be given 1 g iv tranexamic acid along with active management of third stage of labor and control subjects will be given only active management of third stage. Clinical observations and laboratory examinations, measurement of blood loss were measured.Results: Distribution with respect to indication of LSCS like fetal distress, cephalopelvic disproportion, abnormal presentation, previous LSCS, arrest of descent, failed induction and onset of labor were comparable between both the groups. Study group showed marked decrease in blood loss when compared to controls from time of placental delivery to 2 hours postpartum in women undergoing vaginal delivery and caesarean section. There was a significant fall in mean Hb level among the control group when compared with the study group. There was no significant difference in the vital signs of the subjects in both the groups. The incidence of adverse effect like nausea, vomiting and diarrhoea were not increased in the study group when compared to the control group. Also the incidence of thrombosis was not increased with tranexamic acid.Conclusions: Tranexamic acid significantly reduced the amount of blood loss after vaginal delivery and lower segment caesarean section. Its use was not associated with any adverse drug reactions like nausea, vomiting, diarrhoea or thrombosis. Tranexamic acid can be safely administered in pregnant women undergoing vaginal delivery and lower segment caesarean section. 

scholarly journals Efficacy of Tranexamic Acid in Reducing Blood Loss during and After Caesarean Section: A Case control Study

2020 ◽  
Vol 18 (1) ◽  
pp. 22-25
Author(s):  
Kavita Sinha ◽  
Subhash Pandey ◽  
Dipendra Khadka
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Apgar Score ◽  
Postpartum Haemorrhage ◽  
Group Versus ◽  
Control Group ◽  
Study Group ◽  
Lower Segment ◽  
Lower Segment Caesarean Section

Introduction: The incidence of caesarean section is increasing day by day. One of the most common complications is primary or secondary postpartum haemorrhage. Tranexamic acid has been shown to be very useful in reducing blood loss and incidence of blood transfusion in varieties of surgery. Aims: To study the efficacy of tranexamic acid in reducing blood loss during and after the lower segment caesarean section. Methods: Arandomized, case controlled, prospective study was conducted on 100 women undergoing lower segment caesarean section carried out in the Department of Obstetrics and Gynaecology, Nepalgunj Medical College, Kohalpur from Sept 2019 to Feb 2020.Fifty of them were given tranexamic acid immediately before lower segment caesarean section and were compared with 50 others to whom tranexamic acid was not given. Blood loss was collected and measured during two different time interval. The first period was considered from placental delivery to end of lower segment caesarean section and second from the end of lower segment caesarean section to 2 hours postpartum period. Vital signs at time of delivery, at 1 hour and 2 hour postpartum and APGAR score at 1 min and 5 min were studied in both the groups. Results: Tranexamic acid significantly reduced the quantity of blood loss from the placental delivery to 2 hours post-partum: 360.9 ml in the study group, versus 443 ml in the control group (p=0.0008).It also significantly reduced the quantity of blood loss from the end of  lower segment caesarean section to 2 hours postpartum:71.5 ml in the study group versus 112.6 ml in the control group (p=0.0002).There was 18% less incidence of postpartum haemorrhage , who received tranexamic acid(p=0.02).There were no significant adverse drug reaction and difference in APGAR score in both the groups. No complications or side effects were reported in either group. Conclusion: Tranexamic acid is safe and effective in reducing blood loss among women undergoing lower segment caesarean section.

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.

scholarly journals Predicting Factors for Allogeneic Blood Transfusion and Excessive Postoperative Blood Loss after Single Low-Dosage Intra-Articular Tranexamic Acid Application in Total Knee Replacement

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Paphon Sa-ngasoongsong ◽  
Siwadol Wongsak ◽  
Noratep Kulachote ◽  
Pongsthorn Chanplakorn ◽  
Patarawan Woratanarat ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Postoperative Blood Loss ◽  
Total Blood ◽  
Predicting Factors ◽  
Total Knee ◽  
Low Bmi

Background.Recently, intra-articular tranexamic acid (IA-TXA) application has become a popular method for perioperative blood loss (PBL) reduction in total knee replacement (TKR). Nevertheless, through our knowledge, no previous studies had shown the correlation perioperative factors and the risk of excessive PBL or need of blood transfusion (BT) after IA-TXA.Materials and Methods.A retrospective study was conducted in patients underwent 299 primary TKRs, using IA-TXA, during 2-year period (2013-2014). Patient’s characteristic and perioperative data were reviewed and collected. PBL was measured as total hemoglobin loss (THL), estimated total blood loss (ETBL), and drainage volume per kg (DV/kg). Excessive PBL was defined as PBL that exceeded 90th percentile.Results. From multivariate analysis, low preoperative hemoglobin (Hb) level and body mass index (BMI) were the significant predictors of postoperative BT (p<0.0001and 0.003, resp.). Excessive THL significant associated with preoperative Hb (p<0.0001). Excessive ETBL significantly associated with preoperative Hb, height, preoperative range-of-motion, and creatinine clearance (p<0.05all). Low BMI and large prosthesis size were the significant predictors of excessive DV/kg (p=0.0001and 0.002, resp.).Conclusions. Low preoperative Hb and BMI were the significant risks of postoperative transfusion after TKR with IA-TXA. Moreover, multiple perioperative factors could result in higher PBL.

Efficacy of repeated intravenous tranexamic acid in reducing perioperative bleeding of acetabular fractures

2021 ◽  
pp. 1-7
Author(s):  
Chen Xu ◽  
Min Wu ◽  
Zhaodong Wang ◽  
Yajun Liu ◽  
Pinghui Zhou ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Operative Time ◽  
Total Blood Loss ◽  
Postoperative Blood Loss ◽  
Acetabular Fractures ◽  
Control Group ◽  
Transfusion Rate ◽  
Total Blood ◽  
Thrombosis Rate

BACKGROUND: Application of tranexamic acid (TXA) in the treatment of acetabular fractures could reduce intraoperative and postoperative blood loss. OBJECTIVE: To investigate the effect of single and repeated intravenous infusion of TXA on blood loss of acetabular fractures. METHODS: 120 patients with acetabular fractures admitted to our hospital from January 2017 to September 2020 were retrospectively divided into three groups: Patients accepted 1g TXA at preoperative 30 minutes were defined as single TXA group (n = 40); Patients accepted 1g TXA at preoperative 30 minutes and 1g TXA at 3 hours after the start of surgery were defined as repeated TXA group (n = 40); Patients accepted normal saline at preoperative 30 minutes were defined as control group (n = 40). RESULTS: The total blood loss in single TXA group and repeated TXA group were significantly lower than control group, and the total blood loss in the repeated TXA group was significantly lower than single TXA group (P <  0.05). The hidden blood loss from surgery to postoperative 1 day in repeated TXA group was significantly lower than single TXA group and the control group(P <  0.05). No significant differences were observed in the operative time, postoperative transfusion rate and thrombosis rate among the three groups (P >  0.05). CONCLUSION: Repeated TXA is more recommended during acetabular fracture surgery since it can reduce the total blood loss without increasing the operative time, postoperative transfusion rate and thrombosis rate compared with single TXA.

scholarly journals The efficiency and efficacy of tranexamic acid in prevention of blood loss during or after caesarean delivery: a comparative study

2020 ◽  
Vol 9 (4) ◽  
pp. 1549
Author(s):  
Supriya Raina ◽  
V. Suguna ◽  
Padmaja Prabraju
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Normal Saline ◽  
Test Group ◽  
Normal Vaginal Delivery ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Significant Difference

Background: The practice of caesarean section is increasing day by day. Delivery by caesarean section can cause more complications than normal vaginal delivery and one of the most common complications is primary or secondary postpartum hemorrhage. The aim of present study was to study the efficacy and safety of tranexamic acid in reducing blood loss during and after caesarean section.Methods: This study was conducted at Deccan College of Medical Sciences, Hyderabad. It was a prospective randomized double blind placebo controlled study. This study includes 60 pregnant women divided in to two groups. Just before the induction of anesthesia 1 gm of tranexamic acid in 20 ml of normal saline was given over 10 minutes in test group and 20 ml of normal saline was infused in control group.Results: The demographic characters of patients in two groups were comparable. There was no statistically significant difference in the heart rates, respiratory rates and blood pressures in the two groups. There was statistically significant difference in the quantity of the blood loss from during the operation and 2 hours postpartum (p=0.003). Total mean blood loss in control group was 718.80±233.1 ml and in study group was 554.28±207.8 ml. The drop in hemoglobin after caesarean section in study group was not significant where as in control group was significant. There was no significant difference in the prothrombin time and partial thromboplastin time in the groups, pre and post operatively. In this study the use of tranexamic acid reduced the dose of other uterotonics like syntocin in study group.Conclusions: Tranexamic acid significantly reduced the amount of blood loss during the caesarean section and also reduced the use of other uterotonics. Thus, tranexamic acid can be used safely and effectively in subjects undergoing caesarean section.

scholarly journals Postoperative blood loss reduction in computer-assisted surgery total knee replacement by low dose intra-articular tranexamic acid injection together with 2-hour clamp drain: a prospective triple-blinded randomized controlled trial

2011 ◽  
Vol 3 (2) ◽  
pp. 12 ◽  
Author(s):  
Paphon Sa-ngasoongsong ◽  
Thanaphot Channoom ◽  
Viroj Kawinwonggowit ◽  
Patarawan Woratanarat ◽  
Pongsthorn Chanplakorn ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Controlled Trial ◽  
Computer Assisted Surgery ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
Computer Assisted ◽  
Total Blood ◽  
Acid Injection ◽  
Total Knee

A high-dose local tranexamic acid has been introduced in total knee arthroplasty for bleeding control. We are not sure about the systemic absorption and side effects. The aim of this study was to evaluate the effect of low dosage of intra-articular tranexamic acid injection combined with 2-hour clamp drain in minimally bleeding computer-assisted surgery total knee replacement (CAS-TKR). A prospective randomized controlled trial was conducted in a total of 48 patients underwent CAS-TKR. The patients were randomly assigned to receive either of a mixed intra-articular solution of tranexamic acid 250 mg with physiologic saline (TXA group), or physiologic saline (control group) and then followed by clamp drain for 2 hours. Postoperative blood loss was measured by three different methods as drainage volume, total hemoglobin loss and calculated total blood loss. Transfusion requirement and postoperative complications were recorded. All patients were screened for deep vein thrombosis and the functional outcomes were evaluated at 6 months after surgery. The mean postoperative drainage volume, total hemoglobin loss and calculated total blood loss in TXA group were 308.8 mL, 2.1 g/dL and 206.3 mL compared to 529.0 mL, 3.0 g/dL and 385.1 mL in the control group (P=0.0003, 0.0005 and &lt;0.0001 respectively). Allogenic blood transfusion was needed for one patient (4.2%) in TXA group and for eight patients (33.3%) in the control group. Postoperative knee scores were not significantly different between groups. No deep vein thrombosis, infection or wound complication was detected in both groups. In this study, low dose intra-articular tranexamic acid injection combined with 2-hour clamping drain was effective for reducing postoperative blood loss and transfusion requirement in CAS-TKR without significant difference in postoperative complications or functional outcomes.

scholarly journals Prophylactic use of tranexamic acid to reduces blood loss and transfusion requirements in caesarean section

2020 ◽  
Vol 9 (7) ◽  
pp. 2987
Author(s):  
Urmila Sunda ◽  
Priyanka Bhadana
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Postpartum Haemorrhage ◽  
Tertiary Care ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Transfusion Requirements ◽  
The Difference

Background: Postpartum haemorrhage (PPH) is most dreaded complication which occurs worldwide, more prevalent in developing countries after both vaginal and caesarean delivery. Prophylactic administration of a uterotonics immediately after delivery is the only procedure that has been proved to reduce rates of postpartum haemorrhage. Tranexamic acid, an antifibrinolytic is recommended by WHO for management of PPH, its role to reduce blood loss in caesarean section as a prophylactic agent is not well studied.Methods: This study was conducted in a tertiary care hospital at New Delhi total 100 pregnant women with age ≥18 and <35 years and singleton alive fetus who underwent caesarean section were included for this study.  Study population was divided in two group. Women assigned to the study group received 1 gm tranexamic acid slowly intravenously over 10 minutes after delivery of the baby as per existing unit protocol. Those women who received tranexamic acid was compared with other group who did not received tranexamic acid. The primary outcomes were mean blood loss (ml) and mean fall in hemoglobin level within 48 hours after surgery.Results: Amount of blood loss was significantly low (mean 369 ml) in tranexamic acid group as compared to control group (488 ml), the difference was statistically significant (p value 0.001).  Mean fall in haemoglobin level was also low (1.17 mg/dl) in group who received tranexamic acid as compared to control group (1.87 mg/dl), the difference was statistically significant (p value 0.001). Postpartum hemorrhage (blood loss more than 1000 ml) was observed in 1 patient in control group and no case of PPH was observed in study group.Conclusions: Tranexamic acid administration prior to caesarean section was effective in reducing the blood loss intra and postoperative period, without any immediate maternal and neonatal adverse events as well as reduces the need of blood transfusion.

Tranexaminezuur in de gynaecologische en senologische heelkunde: een literatuuroverzicht

2022 ◽  
Author(s):  
J. Wytsman ◽  
K. Traen ◽  
W. Froyman ◽  
E. Despierre
Keyword(s):  
Postoperative Complications ◽  
Blood Transfusion ◽  
Literature Review ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Breast Surgery ◽  
Additional Treatment ◽  
Postoperative Blood Loss ◽  
Intraoperative Blood Loss ◽  
Total Blood

Tranexamic acid in gynecological and breast surgery: a literature review In gynecological and breast surgery, intra- or postoperative blood loss can cause many complications. A large number of interventions have already been described in literature to limit intraoperative blood loss. Tranexamic acid significantly reduces the amount of vaginal blood loss in women with menorrhagia and is also recommended as a treatment for postpartum hemorrhage. Tranexamic acid has been shown to be safe and efficient in limiting blood loss in many other surgical disciplines. In this literature review, the different applications of the use of tranexamic acid in gynecological and breast surgery are explained. The conclusion is that tranexamic acid can be a safe additional treatment that can reduce the total blood loss and the risk of postoperative complications and blood transfusion in various types of gynecological and breast surgery.

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