scholarly journals Effect of intravenous tranexamic acid on blood loss and blood transfusion in total knee replacement: a prospective, randomized study in Indian population

2017 ◽  
Vol 3 (5) ◽  
pp. 916
Author(s):  
Shivakumar Kerakkanavar ◽  
Raghavendra Venkatesh ◽  
K. M. Gopinath ◽  
Pramodkumar M.
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Primary Total Knee Replacement ◽  
Group I ◽  
Total Knee ◽  
Group Ii ◽  
Primary Total Knee

<p class="abstract"><strong>Background:</strong> Tranexamic acid (TXA) is antifibrinolytic drug which has the property to reduce intraoperative and postoperative bleeding. There are several studies supporting the use of tranexamic acid in total knee replacements (TKR) and few in total hip replacements. Our study was intended to establish the effects of tranexamic acid in minimizing the intra operative and post-operative blood loss in uncomplicated primary total knee replacement.</p><p class="abstract"><strong>Methods:</strong> This was a prospective follow up study conducted in Rajarajeshwari Medical College and Hospital Bangalore, over a period of 14 months from June 2015 to August 2016. A total number of 60 patients who underwent unilateral primary total knee replacement were included for this study. They were randomly divided into 2 groups. Group I patients infused (intravenous) with 20 mg/kg TXA before incision and 3 hours after surgery whereas no TXA was administered in Group II. Total blood loss and transfusion rate were used as outcome. <strong></strong></p><p class="abstract"><strong>Results:</strong> Mean amounts of blood loss were 578 ml in Group 1 and 946 ml in Group 2. There was a decrease in blood loss in TXA groups (p&lt;0.001). Transfusion was required in 6 patients of Group I and 17 patients of Group II (p&lt;0.001). No thromboembolic problem was seen in any patients.</p><p><strong>Conclusions:</strong> Since TXA decrease perioperative blood loss and lessen the need for blood transfusion significantly, without increasing thromboembolic events in TKR. We suggest using intravenous (IV) TXA in TKR. </p>

scholarly journals Local infiltration of analgesia and tranexamic acid is safe and efficacious in reducing blood loss and comparable to intra-articular tranexamic acid in total knee replacements

2021 ◽  
Author(s):  
H Sivasubramanian ◽  
CMP Tan ◽  
L Wang
Keyword(s):  
Pain Relief ◽  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Functional Outcomes ◽  
Primary Total Knee Replacement ◽  
Total Knee ◽  
The Mean ◽  
Primary Total Knee

Introduction: The use of peri-articular (PA) tranexamic acid (TXA) and its efficacy in comparison with intra-articular (IA) tranexamic acid has not been well explored in literature. This retrospective cohort study aims to compare the effects of IA and PA TXA with analgesic components in reducing blood loss and improving immediate post-operative pain relief and functional outcomes in unilateral primary total knee replacement (TKA) patients. Methods: 63 patients who underwent a unilateral primary total knee replacement procedure were divided into 2 groups: 42 patients in the IA TXA delivery group, 21 patients in the PA TXA group. 1g of TXA was utilized for all patients. All patients had pericapsular infiltration consisting of 0.5ml of Adrenaline, 0.4ml of Morphine, 1g of Vancomycin, 1ml of Ketorolac and 15ml of Ropivacaine. Outcomes for blood loss, and surrogate markers for immediate functional recovery were measured. Results: 54.0% of the patients were female, 46.0% male. The mean drop in post-operative Hb levels in the PA and IA group was 2.0g/dL and 1.6 g/dL respectively, and statistically insignificant (p=0.10). The mean HCT drop in the PA and IA group was 6.1% and 5.3% respectively and statistically insignificant (p=0.58). The POD 1 and discharge day flexion angles, POD 1 and POD 2 VAS scores, gait distance on discharge, and length of hospitalization stay were largely similar in both groups. Conclusion: Our study shows that both IA and PA TXA with analgesic components are equally efficient in reducing blood loss and improving immediate postoperative pain relief and functional outcomes.

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 Use of tranexamic acid in primary total knee replacement: effects on perioperative blood loss

2016 ◽  
Vol 66 (3) ◽  
pp. 254-258
Author(s):  
Daniel Volquind ◽  
Remi Antônio Zardo ◽  
Bruno Costamilan Winkler ◽  
Bruno Bertagnolli Londero ◽  
Natália Zanelatto ◽  
...  
Keyword(s):  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Perioperative Blood Loss ◽  
Primary Total Knee Replacement ◽  
Total Knee ◽  
Primary Total Knee

Topical Intra-Articular Compared with Intravenous Tranexamic Acid to Reduce Blood Loss in Primary Total Knee Replacement

2014 ◽  
Vol 96 (23) ◽  
pp. 1937-1944 ◽  
Author(s):  
Enrique Gomez-Barrena ◽  
Miguel Ortega-Andreu ◽  
Norma G. Padilla-Eguiluz ◽  
Hanna Pérez-Chrzanowska ◽  
Reyes Figueredo-Zalve
Keyword(s):  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Reduce Blood Loss ◽  
Primary Total Knee Replacement ◽  
Total Knee ◽  
Primary Total Knee

scholarly journals A comparison of blood loss and the need for transfusion following primary total knee replacement with or without the use of a tourniquet

2018 ◽  
Vol 4 (4) ◽  
pp. 532 ◽  
Author(s):  
Sayyied J. Kirmani ◽  
Mark Middleton ◽  
Andreas Fontalis ◽  
Raka Srivastava ◽  
Feroz Dinah
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
The Body ◽  
Operative Blood Loss ◽  
Primary Total Knee Replacement ◽  
Transfusion Requirements ◽  
Total Knee ◽  
Primary Total Knee

<p class="abstract"><strong>Background:</strong> Primary total knee replacement (TKR) has traditionally been carried out with the use of a tourniquet. More recent trends towards performing the surgery without a tourniquet have had some support in the literature and may improve patient recovery.</p><p class="abstract"><strong>Methods:</strong> A retrospective cohort of 198 consecutive primary TKRs from our institution were identified and analysed, 52 used a tourniquet and 146 did not. All TKRs also utilised a standardised interventions protocol including withholding of anticoagulants and antiplatelet medications, topical adrenaline injection, and both IV and topical tranexamic acid. Outcomes measured were estimated intra-operative blood loss, overall blood loss through comparison of pre and post-operative haemoglobin laboratory values, and the need for post-operative blood transfusion.<strong></strong></p><p class="abstract"><strong>Results:</strong> Analysis demonstrated a statistically significant reduction in estimated intra-operative blood loss when a tourniquet was used (p&lt;0.001). However, overall blood loss indicated by the haemoglobin drop after surgery was not significantly affected by tourniquet use (p=0.342). Transfusion requirements were also similar among the groups (4.8% vs. 5.8%) and no tendency was suggested towards an increased rate of transfusion in the non-tourniquet group.</p><p class="abstract"><strong>Conclusions:</strong> Our study shows that although estimated intra-operative blood loss is increased without a tourniquet, total blood loss as measured by haemoglobin levels is no different for primary TKRs that use a tourniquet and those that do not. Furthermore there is no difference in post-operative blood transfusion rates. It is our hope that this study will add to the body of evidence for surgeons to consider no longer using a tourniquet for primary TKR.</p>

Sign in / Sign up

Export Citation Format

Share Document