scholarly journals Randomised trial of mefenamic acid versus tranexamic acid in management of menorrhagia

2017 ◽  
Vol 6 (10) ◽  
pp. 4608
Author(s):  
Madhu J. ◽  
Shylaja A. S.
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Mefenamic Acid ◽  
Randomised Trial ◽  
Menstrual Blood ◽  
Menstrual Blood Loss ◽  
Loss Assessment ◽  
Group A ◽  
Group B ◽  
To Receive

Background: The objective of the study was to compare the efficacy of mefenamic acid, a non-inflammatory drug with tranexamic acid, an antifibrinolytic drug in management of menorrhaghia.Methods: Randomised trial of women attending outpatient department of St. Philomena’s hospital, Bangalore with complaints of menorrhagia. Fifty four patients with complaints of menorrhagia were randomly assigned to receive either mefenamic acid 500 mg tid (group A- 24 patients) or tranexamic acid 1 gm TID (group B- 26 patients) from day one to day five for three consecutive menstrual cycles.Results: Reduction in menstrual blood loss as assessed by pictoral blood loss assessment chart was more in group B (50%) than in Group A (30%) (ANOVA, covariates with F=59.647, p<0.001). Difference in improvement of dysmenorrhoea was not statistically significant (p=0.640). Side effects were less in group B compared to group A (p=0.271). Post treatment Hb% significantly improved in both groups (p=0.015 in group A, p<0.001 in gr B). Acceptability was statistically similar in both groups (p>0.05).Conclusions: Both mefenamic acid and tranexamic acid were effective in management of menorrhagia. Tranexamic acid was significantly superior to mefenamic acid in terms of reduction in menstrual blood loss.

scholarly journals Multiple intravenous tranexamic acid doses in total knee arthroplasty in patients with rheumatoid arthritis: a randomized controlled study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Bing-xin Kang ◽  
Hui Xu ◽  
Chen-xin Gao ◽  
Sheng Zhong ◽  
Jing Zhang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Randomized Controlled ◽  
Group A ◽  
Total Knee ◽  
Group B ◽  
D Dimer

Abstract Background We aimed to determine the efficacy and safety of multiple doses of intravenous tranexamic acid (IV-TXA) on perioperative blood loss in patients with rheumatoid arthritis (RA) who had undergone primary unilateral total knee arthroplasty (TKA). Methods For this single-center, single-blind randomized controlled clinical trial, 10 male and 87 female participants with RA, aged 50–75 years, who underwent unilateral primary TKA were recruited. The patients received one dose of 1 g IV-TXA 10 min before skin incision, followed by articular injection of 1.5 g tranexamic acid after cavity suture during the surgery. The patients were randomly assigned (1:1) into two groups and received an additional single dose of IV-TXA (1 g) for 3 h (group A) or three doses of IV-TXA (1 g) for 3, 6, and 12 h (group B) postoperatively. Primary outcomes were total blood loss (TBL), hidden blood loss (HBL), and maximum hemoglobin (Hb) level decrease. Secondary outcomes were transfusion rate and D-dimer levels. All parameters were measured postoperatively during inpatient hospital stay. Results The mean TBL, HBL, and maximum Hb level decrease in group B (506.1 ± 227.0 mL, 471.6 ± 224.0 mL, and 17.5 ± 7.7 g/L, respectively) were significantly lower than those in group A (608.8 ± 244.8 mL, P = 0.035; 574.0 ± 242.3 mL, P = 0.033; and 23.42 ± 9.2 g/L, P = 0.001, respectively). No episode of transfusion occurred. The D-dimer level was lower in group B than in group A on postoperative day 1 (P <  0.001), and the incidence of thromboembolic events was similar between the groups (P > 0.05). Conclusion In patients with RA, three doses of postoperative IV-TXA further facilitated HBL and Hb level decrease without increasing the incidence of adverse events in a short period after TKA. Trial registration The trial was registered in the Chinese Clinical Trial Registry (ChiCTR1900025013).

scholarly journals Intravenous and subsequent long-term oral tranexamic acid in enhanced-recovery primary total knee arthroplasty without the application of a tourniquet: a randomized placebo-controlled trial

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Hao-Yang Wang ◽  
Liu Wang ◽  
Ze-Yu Luo ◽  
Duan Wang ◽  
Xin Tang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Total Blood ◽  
Significant Difference ◽  
Group A ◽  
Total Knee ◽  
Group B

Abstract Background To assess the efficacy and safety of intravenous and subsequent long-term oral tranexamic acid (TXA) following total knee arthroplasty (TKA) without a tourniquet. Methods In this double-blinded trial, 118 patients undergoing primary TKA were randomized into two groups: the patients in group A received intravenous TXA at 20-mg/kg 10 min before the surgery and 3 h postoperatively, and then oral 1 g TXA from postoperative day (POD) 1 to POD 14, and the patients in group B received intravenous TXA at 20-mg/kg 10 min before surgery and 3 h postoperatively, and then oral 1 g placebo from postoperative day (POD) 1 to POD 14. The primary outcome was total blood loss. Secondary outcomes included ecchymosis area and morbidity, postoperative transfusion, postoperative laboratory values, postoperative knee function and length of hospital stay. Complications, and patient satisfaction were also recorded. Results The mean total blood loss was lower in Group A than in Group B (671.7 ml vs 915.8 ml, P = 0.001). There was no significant difference in the transfusion rate between the two groups. Group A had a higher hemoglobin than Group B on POD 3 (106.0 g/L vs 99.7 g/L, P = 0.001). However, no significant difference was found for Hb or hematocrit on POD 1 or POD 14 between the two groups. Patients in Group A had less ecchymosis morbidity (7 vs 38, P = 0.001), smaller ecchymosis area (1.6 vs 3.0, P = 0.001) than Group B. The blood coagulation level as measured by fibrinolysis (D-Dimer) was lower in Group A than in Group B on POD 1 and POD 3 (4.6 mg/L vs. 8.4 mg/L, respectively, P = 0.001; 1.5 mg/L vs. 3.3 mg/L, respectively, P = 0.001). However, there was no significant difference on POD 14, and the fibrin degradation products showed the same trend. Patients in Group A had less swelling than those in Group B on POD 3 and POD 14. The circumference of the knee was 43.1 cm vs. 46.1 cm (POD 3, P = 0.001) and 41.4 cm vs. 44.9 cm (POD 14, P = 0.001) in Group A vs Group B, respectively. Nevertheless, the circumference of the knee in the two groups was similar on POD 1 and POD 3 M. No significant differences were identified in knee function, pain score, or hospital stay. No significant differences were identified in thromboembolic complications, infection, hematoma, wound healing and patients satisfaction between the two groups. Conclusion Intravenous and subsequent long-term oral TXA produced less blood loss and less swelling and ecchymosis compared with short-term TXA without increasing the risk of complications. Trial registration The trial was registered in the Chinese Clinical Trial Registry (ChiCTR-IPR-17012264).

scholarly journals Pictorial blood loss assessment chart for quantification of menstrual blood loss: a systematic review

2015 ◽  
Vol 12 (3) ◽  
pp. 157-163 ◽  
Author(s):  
Sherif A. El-Nashar ◽  
Sherif A. M. Shazly ◽  
Abimbola O. Famuyide
Keyword(s):  
Systematic Review ◽  
Blood Loss ◽  
Menstrual Blood ◽  
Menstrual Blood Loss ◽  
Loss Assessment

scholarly journals Intraarticular vs Intravenous Tranexamic Acid in Reduction of Blood Loss in Primary Total Knee Replacement

2016 ◽  
Vol 50 (2) ◽  
pp. 64-68
Author(s):  
Arunkumar Vijay ◽  
Jambu Nageswaran ◽  
Senthil Loganathan ◽  
Samuel Chittaranjan Bedford
Keyword(s):  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Primary Total Knee Replacement ◽  
Group A ◽  
Total Knee ◽  
The Mean ◽  
Group B ◽  
Primary Total Knee

ABSTRACT Aim To study the efficacy of topical intraarticular vs intravenous tranexamic acid (TXA) in reducing blood loss following primary total knee replacement (TKR). Materials and methods A phase 3, single center, double blind and randomized controlled study was conducted in the Department of Orthopedics, Sri Ramachandra University, Chennai, Tamil Nadu. A prospective study of 100 patients lasted from July 2013 to July 2015. Results Postoperative transfusion rates were zero in both the groups (intraarticular and intravenous). The mean 48-hour drain collected is 285.6 ml in group A (intraarticular), while it is 325.8 ml in group B (intravenous); the mean drop in hemoglobin is 1.7 gm/dl in group A (intraarticular) while it is 2.4 gm/dl in group B (intravenous). Conclusion This study shows that topical intraarticular administration of TXA has better efficacy than intravenous TXA in controlling postoperative blood loss following primary uncomplicated TKR with no significant complications. How to cite this article Vijay A, Nageswaran J, Loganathan S, Bedford SC. Intraarticular vs Intravenous Tranexamic Acid in Reduction of Blood Loss in Primary Total Knee Replacement. J Postgrad Med Edu Res 2016;50(2):64-68.

scholarly journals Multiple-dose tranexamic acid for perioperative blood loss in total knee arthroplasty in patients with rheumatoid arthritis：a single-blinded, randomised, parallel-controlled study protocol in China

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e034431
Author(s):  
Bing-Xin Kang ◽  
Hui Xu ◽  
Chen-Xin Gao ◽  
Sheng Zhong ◽  
Jing Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Intravenous Injection ◽  
Knee Arthroplasty ◽  
Multiple Dose ◽  
Controlled Study ◽  
Group A ◽  
Total Knee ◽  
Group B

IntroductionThis clinical trial is designed to evaluate the effect of multiple-dose tranexamic acid (TXA) on perioperative blood loss in patients with rheumatoid arthritis (RA).Methods and analysisA randomised, single-blinded, parallel-controlled study will be designed. Patients with RA (age 50–75 years) undergoing unilateral primary end-stage total knee arthroplasty will be randomly divided into group A or group B. Group A will be treated with one dose of TXA (1 g; intravenous injection 3 hours postsurgery) and group B with three doses (1 g; intravenous injection at 3, 6 and 12 hours postsurgery) after surgery. The primary outcomes will be evaluated with blood loss, maximum haemoglobin drop and transfusion rate. The secondary outcomes will be evaluated with knee function and complications.Ethics and disseminationThe Shanghai Guanghua Hospital of Integrated Traditional Chinese Medicine and Western Medicine Ethics Committee approved in this study in July 2019. Informed consent will be obtained from all participants. Results of the trial will be published in the Dryad and repository in a peer-reviewed journal. Additionally, deidentified data collected and analysed for this study will be available for review from the corresponding author on reasonable request.Trial registration numberChiCTR1900025013.

Single Intravenous Bolus versus Continuous Infusion of Tranexamic Acid to Reduce Blood Loss in Transurethral Resection of Prostate: a Prospective Randomized Double-Blind Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Safaa I Ghaly ◽  
Marwa A Khairy ◽  
Mohamed M Kamal ◽  
Eman A Mohammed
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Transurethral Resection ◽  
Bolus Dose ◽  
Transurethral Resection Of Prostate ◽  
Intraoperative Blood Loss ◽  
Operative Blood Loss ◽  
Single Bolus Dose ◽  
Group A ◽  
Group B

Abstract Background and aim Intraoperative use of a single bolus dose of tranexamic acid may not be sufficient to prevent bleeding in the early postoperative period. The present study was carried out to compare the effect of two dose regimens of tranexamic acid in reducing perioperative blood loss and the amount of allogeneic blood transfusion in transurethral resection of prostate. Design prospective, double-blinded and controlled study. Setting Ain Shams University Hospital, Patients and Methods 50 patients electively posted for transurethral resection of prostate were randomly assigned to receive a single bolus dose of tranexamic acid (10 mg/kg) (Group A), a bolus dose of tranexamic acid (10 mg/kg) followed by infusion (1 mg/kg/h) till 4 h postoperatively (Group B). Measurements Total intraoperative blood loss, amount of allogeneic blood transfusion, postoperative drain collections, and hemoglobin and hematocrit levels were recorded at different time intervals. Data obtained after comparing two groups were analyzed using the statistical package for social sciences. Results There was no statistically significant difference among patients in both groups regarding intraoperative blood loss and postoperative blood loss at 6 hrs and 48 hrs postoperatively. However the post-operative blood loss at 24 hrs was significantly higher among patients in group A than patients in group B (P-value= 0.014) . Conclusion Tranexamic acid causes more effective reduction in post-operative blood loss when used as a bolus followed by an infusion continued in the postoperative period in comparison to its use as a single intravenous bolus in transurethral resection of prostate.

scholarly journals Tranexamic Acid in Pertrochanteric Femoral Fracture: Is it a Safe Drug or Not?

Folia Medica ◽  
2018 ◽  
Vol 60 (1) ◽  
pp. 67-78 ◽  
Author(s):  
Andrea Schiavone ◽  
Michele Bisaccia ◽  
Ivan Inkov ◽  
Giuseppe Rinonapoli ◽  
Mattia Manni ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Vascular Events ◽  
Safety Criterion ◽  
Post Surgery ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
D Dimer

AbstractBackground:There is a high incidence of blood transfusion following hip fractures in elderly patients.Aim:The aim of this study is to evaluate the effectiveness and complications of use of tranexamic acid in proximal femur nailing surgery.Materials and methods:Our sample group consisted of 90 patients suffering from pertrochanteric fractures surgically treated with osteosynthesis with SupernailGT(LimaCorporate). The classification system AO/OTA was used to divide the fractures into 31A1 (n=45) and 31A2 (n=45). The patients were divided into two groups: 47 patients were administered 15 mg of tranexamic acid per kg (group A) and 43 patients were administered placebo (group B). Blood counts were monitored daily to evaluate the rate of anemia. As a safety criterion, we monitored the possible occurrence of vascular events, symptomatic or not, over the 8 weeks post-surgery. Markers predicting mortality and deep venous thrombosis (DVE) were also monitored (fibrinogen D-dimer).Results:Blood loss occurring post-surgery can be influenced by numerous factors that are not linked to the use or non-use of tranexamic acid. While closely monitoring hemoglobin levels daily, we observed that 42% of the patients in group A required blood transfusion as opposed to 60% in group B. The results of the markers predicting mortality (alpha1-acid glycoprotein; albumin LDL) and those of DVE were not statistically significant between the two groups in this study (p>0.05).Conclusion:Based on this study, the use of tranexamic acid was statistically significant in reducing post-surgery blood loss.

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