scholarly journals Does tranexamic acid have role in controlling intraoperative blood loss in tonsillectomy?

2020 ◽  
Vol 6 (7) ◽  
pp. 1253
Author(s):  
Heempali Das Dutta ◽  
Pabina Rayamajhi ◽  
Nazeef Ibrahim
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Postoperative Bleeding ◽  
University Teaching ◽  
Control Group ◽  
Study Group ◽  
Intraoperative Blood Loss ◽  
Intraoperative Bleeding ◽  
The Difference ◽  
And Control

<p class="abstract"><strong>Background:</strong> The study was done with the objective to assess the effect of tranexamic acid in controlling intraoperative bleeding in tonsillectomy.</p><p class="abstract"><strong>Methods:</strong> Retrospective study was conducted in the Department of ENT and HNS, Tribhuvan University Teaching Hospital, Kathmandu, Nepal from August 2016 to July 2017. Patients more than 15 years who underwent bilateral tonsillectomy were included in the study. Whereas patients who underwent unilateral tonsillectomy and patients who had hypersensitivity to tranexamic acid were excluded from the study. The patients who received tranexamic acid during surgery were taken as study group whereas the patients who didn’t receive tranexamic acid were taken as control. The amount of the intraoperative blood loss, i.e. mean and the frequency of early post-operative bleeding were evaluated.  </p><p class="abstract"><strong>Results:</strong> A total of 48 patients who fulfilled the inclusion criteria were evaluated. Among whom, 24 patients who received tranexamic acid during tonsillectomy were taken as study group and other 24 patients who did not received tranexamic acid were taken as control. The mean blood loss in study and control group were 92.85 ml and 91.40 ml respectively and the difference was statistically not significant (p=0.785). There were no cases of early postoperative bleeding recorded in either group within the first 24 hours of surgery.</p><p><strong>Conclusions:</strong> There is no significant role of tranexamic acid in controlling intraoperative bleeding in tonsillectomy. </p>

scholarly journals Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Study Group ◽  
Mortality And Morbidity ◽  
Lower Segment Cesarean Section ◽  
Prophylactic Use

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.

scholarly journals The Efficacy of Intravenous Tranexamic Acid in Reduction of Blood Loss in Women at High Risk of Postpartum Hemorrhage

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K M Diab ◽  
R M Mohamed ◽  
A G Abdelhay
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Maternal Mortality ◽  
Vaginal Delivery ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Significant Difference ◽  
And Control

Abstract Background Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period. Patients and Methods This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology. Results No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p &lt; 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p &lt; 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p &lt; 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hematocrite was significantly less in study group than control group (p &lt; 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24). Conclusion The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.

scholarly journals Effects of tranexamic acid in major orthopedic surgical procedures: a randomized comparative study

2019 ◽  
Vol 5 (4) ◽  
pp. 551
Author(s):  
Uganath Subash B. ◽  
Sundaramoorthy M.
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Surgical Procedures ◽  
Orthopedic Surgery ◽  
Control Group ◽  
Orthopedic Surgical Procedures ◽  
The Mean ◽  
The Difference ◽  
And Control

<p class="abstract"><strong>Background:</strong> Despite modern healthcare system, major surgeries always cause economical constraints. Complications due to blood loss, long hospital stay are most common in major surgical procedures. Tranexamic acid (TXA), a synthetic derivative of lysine is used instead of blood transfusion to control bleeding peri and post operatively.<strong> </strong>Hence this study was planned to assess the effects of tranexamic acid on various orthopedic surgical procedures, in terms of blood loss, duration of surgical procedure and hospital stay.</p><p class="abstract"><strong>Methods:</strong> Prospective randomized comparative study, among patients undergoing elective and emergency orthopedic surgery. Patients with multiple fractures, organ injury and CKD were excluded from this study. Patients were randomized to tranexamic acid (TXA) group and colloids, blood transfusion group based on computer generated random numbers. Thirty two patients were randomized to tranexamic acid group and thirty two in control group. Statistical analysis was done using SPSS V 20.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age group was 38.41±11.4 and 36.83±13.5 in TXA group and control group respectively. The mean SD for blood loss in TXA group was 321.5±124.7 and control group 482.7±189.6, the difference was found to be highly statistically significant with p=0.0002. Likewise the difference in postoperative Hb was found to be statistically significant with p&lt;0.01. The p value for surgical site infection and hematoma was not statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> TXA significantly reduces blood loss and blood transfusion requirements in patients undergoing orthopedic surgery.</p>

scholarly journals Placenta previa with posterior extrauterine adhesion: clinical features and management practice

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshikazu Nagase ◽  
Shinya Matsuzaki ◽  
Masayuki Endo ◽  
Takeya Hara ◽  
Aiko Okada ◽  
...  
Keyword(s):  
Propensity Score ◽  
Blood Loss ◽  
Cesarean Delivery ◽  
Clinical Features ◽  
Surgical Outcomes ◽  
Multivariate Regression ◽  
Placenta Previa ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Intraoperative Bleeding

Abstract Background A diagnostic sign on magnetic resonance imaging, suggestive of posterior extrauterine adhesion (PEUA), was identified in patients with placenta previa. However, the clinical features or surgical outcomes of patients with placenta previa and PEUA are unclear. Our study aimed to investigate the clinical characteristics of placenta previa with PEUA and determine whether an altered management strategy improved surgical outcomes. Methods This single institution retrospective study examined patients with placenta previa who underwent cesarean delivery between 2014 and 2019. In June 2017, we recognized that PEUA was associated with increased intraoperative bleeding; thus, we altered the management of patients with placenta previa and PEUA. To assess the relationship between changes in practice and surgical outcomes, a quasi-experimental method was used to examine the difference-in-difference before (pre group) and after (post group) the changes. Surgical management was modified as follows: (i) minimization of uterine exteriorization and adhesion detachment during cesarean delivery and (ii) use of Nelaton catheters for guiding cervical passage during Bakri balloon insertion. To account for patient characteristics, propensity score matching and multivariate regression analyses were performed. Results The study cohort (n = 141) comprised of 24 patients with placenta previa and PEUA (PEUA group) and 117 non-PEUA patients (control group). The PEUA patients were further categorized into the pre (n = 12) and post groups (n = 12) based on the changes in surgical management. Total placenta previa and posterior placentas were more likely in the PEUA group than in the control group (66.7% versus 42.7% [P = 0.04] and 95.8% versus 63.2% [P < 0.01], respectively). After propensity score matching (n = 72), intraoperative blood loss was significantly higher in the PEUA group (n = 24) than in the control group (n = 48) (1515 mL versus 870 mL, P < 0.01). Multivariate regression analysis revealed that PEUA was a significant risk factor for intraoperative bleeding before changes were implemented in practice (t = 2.46, P = 0.02). Intraoperative blood loss in the post group was successfully reduced, as opposed to in the pre group (1180 mL versus 1827 mL, P = 0.04). Conclusions PEUA was associated with total placenta previa, posterior placenta, and increased intraoperative bleeding in patients with placenta previa. Our altered management could reduce the intraoperative blood loss.

scholarly journals Safety and effectiveness evaluation of a two-handed technique combining harmonic scalpel and laparoscopic Peng’s multifunction operative dissector in laparoscopic hemihepatectomy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jingwei Cai ◽  
Guixing Jiang ◽  
Yuelong Liang ◽  
Yangyang Xie ◽  
Junhao Zheng ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Peak Level ◽  
Bile Leakage ◽  
Liver Parenchyma ◽  
Control Group ◽  
Case Group ◽  
Intraoperative Blood Loss ◽  
And Control

Abstract Objectives This study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng’s multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH). Methods We designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January 2016 to May 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. Results The case group had significantly less intraoperative blood loss in milliliters (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate, and others were comparable between the two groups. There was no perioperative mortality. Conclusions We demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.

scholarly journals True and Pseudo Cholinesterase levels in short and long-term of pesticides exposures

2020 ◽  
pp. 9-12
Author(s):  
Mohammed Abdul Rahman ◽  
Raghunatha Rao D ◽  
Vasantha L
Keyword(s):  
Whole Blood ◽  
Acute Poisoning ◽  
Mean Value ◽  
Serum Cholinesterase ◽  
Control Group ◽  
Study Group ◽  
Chronic Poisoning ◽  
The Mean ◽  
The Difference ◽  
And Control

The present study is aimed to study and analyze the true and pseudo Cholinesterase levels in the subjects exposed to pesticides during short term by intentional or accidental intake and long term exposure due to their occupation were studied at Department of Biochemistry, SVS medical college and hospital mahbubnagar district. Whole blood cholinesterase levels and Pseudo cholinesterase levels were estimated. 150 people were taken as controls who had no medical illness and a total number of 300 cases of pesticide poisoning were selected, aged between 20 to 55 years, which consist of 150 acute poisoning and 150 chronic poisoning subjects in Mahbubnagar district, were taken as case study, the detailed case history and the type of organophosphorus pesticide taken were recorded. Mean and standard deviation (S.D) of all variables were calculated and compared with those of controls. Statistical significance was assessed and P-value <0.05 were considered significant.           During acute poisoning the mean value of Whole blood cholinesterase/True cholinesterase (U / L) in acute poisoning cases on first day was 1.267± 0.612 on 3th day was 1.651±0.647, on 7th day was 2.221±0.684 and at the end of 6 months was 3.970±0.404.The difference between the study group and control group (4.0 ± 0.39) was found to be statistically significant in1st, 3rd, 7th day but not significant at the end of 6 months. The mean value of serum cholinesterase/pseudo cholinesterase (U/L) in acute poisoning cases on first day was 2213.05 ± 1749.81, on 3th day was 2862.3 ± 2025.6, on 7th day was 4008.4 ± 2355.9 and at the end of 6 months was 7708.34 ± 880.72.The difference between the study group and control group (7991.97 ± 1276.5) was found to be statistically significant in1st, 3rd, 7th day but not significant at the end of 6 months. During chronic poisoning (exposure) the mean value of Whole blood cholinesterase (U/L) in controls is 4.0 ± 0.39 as compared to 3.019 ± 0.848 in cases of chronic poisoning. The difference between the study group and control group was found to be statistically significant. The mean value of serum cholinesterase/pseudo cholinesterase (U/L) in controls was 7991.97 ± 1276.5 as compared to 6214 ± 1189 in cases of chronic poisoning. The difference between the study group and control group was found to be statistically significant.

scholarly journals Perioperative blood loss in total hip and knee arthroplasty: Outcomes associated with intravenous tranexamic acid use in an academic medical center

2016 ◽  
Vol 4 ◽  
pp. 205031211663702 ◽  
Author(s):  
Craig A Hogan ◽  
Larry K Golightly ◽  
Suzanne Phong ◽  
Michael R Dayton ◽  
Clark Lyda ◽  
...  
Keyword(s):  
Treatment Group ◽  
Blood Loss ◽  
Confidence Interval ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Control Group ◽  
Control Groups ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
And Control

Objectives: Clinical trials have reported decreased blood loss with the use of tranexamic acid during joint reconstruction. The purpose of this study was to assess the individual practice implications of tranexamic acid use in joint replacement surgery. Methods: Health records of adults undergoing total knee arthroplasty and total hip arthroplasty over a 12-month period were retrospectively reviewed. The treatment group comprised patients who received intravenous tranexamic acid perioperatively. The control group comprised patients who did not receive tranexamic acid. Results: Patients in the treatment group (n = 64) and the control group (n = 99) were well matched for demographics, orthopedic diagnosis, and comorbidities. In-hospital postsurgical mean decreases in hemoglobin concentrations were −4.05 g/dL and −4.94 g/dL in the treatment and control groups, respectively (p < 0.001). Postsurgical mean decreases in hematocrit levels were −11.2% and −14.2% in the treatment and control groups, respectively (p < 0.001). Three patients in the treatment group (5%) and 21 patients in the control group (21%) received red blood cell transfusions (p = 0.006). As compared to control, the relative risk of transfusion in the treatment group was 0.23 (95% confidence interval = 0.07–0.76) and the number needed to treat to avoid one transfusion was 7.0 (95% confidence interval = 3.8–14.4). No evidence of thromboembolism or other serious complications were observed in either group. Conclusions: In patients undergoing joint replacement surgery, perioperative administration of tranexamic acid was associated with diminished blood loss and lesser resource utilization.

scholarly journals The effects of intra-articular tranexamic acid given intraoperatively and intravenous tranexamic acid given preoperatively on post surgical bleeding and transfusion rate post total knee arthroplasty

2017 ◽  
Vol 25 (4) ◽  
pp. 234-9 ◽  
Author(s):  
Aryo N. Triyudanto ◽  
Andri M.T. Lubis
Keyword(s):  
Blood Transfusion ◽  
Tranexamic Acid ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Transfusion Rate ◽  
Intraoperative Bleeding ◽  
Post Surgery ◽  
Drain Removal ◽  
Significant Difference ◽  
Total Knee

Background: Despite the advances in the design and fixation of implants in total knee replacement (TKR). the amount of postoperative bleeding is still an important issue that has not been resolved. This study aimed to measure the effectiveness of various tranexamic acid administration. Methods: This was a randomized controlled trial study, held from August 2014 to February 2016 at Cipto Mangunkusumo Hospital, Jakarta. Twenty two patients having TKR were divided into three groups: the control group, the tranexamic acid intra-articular-intraoperative group, and the intravenous preoperative group. Intraoperative bleeding, haemoglobin (Hb) level on preoperative to five-day-post-surgery, total drain production, total blood tranfusion needed and the drain removal timing were recorded and compared. Numerical data were analyzed by using parametric and non-parametric test, depended on the normality of the data. Results: The amount of blood transfusion needed in both the intra-articular group (200±SD 100 mL) and the intravenous group (238±SD 53 mL) were significantly different compared to those in the control group (1,016±SD 308.2 mL) (p=0.001). Meanwhile, there was no significant difference between the amount of blood transfusion needed in the intra-articular group and the intravenous group. Total drain production in the intra-articular group (328±SD 193 mL) and intravenous group (391±SD 185 mL) was significantly different compared to the control group (652±SD 150 mL) (p=0.003). No significant difference between the levels of both preoperative and postoperative haemoglobin, the amount of intraoperative bleeding, and the duration of drain usage. Conclusion: Intravenous and intra-articular tranexamic acid effectively decreased transfusion volume and drain production in patients undergoing TKR.

Cytomorphometric and Morphological Analysis in Women with Trichomonas vaginalis Infection: Micronucleus Frequency in Exfoliated Cervical Epithelial Cells

2015 ◽  
Vol 59 (3) ◽  
pp. 258-264 ◽  
Author(s):  
Zehra Safi Oz ◽  
Banu Doğan Gun ◽  
Mustafa Ozkan Gun ◽  
Sukru Oguz Ozdamar
Keyword(s):  
Epithelial Cells ◽  
Trichomonas Vaginalis ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
The Mean ◽  
The Difference ◽  
Group 2 ◽  
And Control ◽  
Group 1

Objectives: The aim of this study was to explore the cytomorphometric and morphological effects of Trichomonas vaginalis in exfoliated epithelial cells. Study Design: Ninety-six Pap-stained cervical smears were divided into a study group and two control groups as follows: T. vaginalis cases, a first control group with inflammation, and a second control group without inflammation. Micronucleated, binucleated, karyorrhectic, karyolytic, and karyopyknotic cells and cells with perinuclear halos per 1,000 epithelial cells were counted. Nuclear and cellular areas were evaluated in 70 clearly defined cells in each smear using image analysis. Results: The frequencies of morphological parameters in the T. vaginalis cases were higher than the values of the two control groups, and the difference among groups was found to be significant (p < 0.05). The nuclear and cytoplasmic areas of epithelial cells were diminished in patients with trichomoniasis. The mean nucleus/cytoplasm ratio in T. vaginalis patients was higher than the value in the control groups, and the difference between the study group and control group 1 was significant. However, there was no statistically significant increase between the study group and control group 2. Conclusions:T. vaginalis exhibited significant changes in the cellular size and nuclear structure of the cells. The rising frequency of micronuclei, nuclear abnormalities, and changing nucleus/cytoplasm ratio may reflect genotoxic damage in trichomoniasis.

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.

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