scholarly journals Effect of tranexamic acid on blood loss, coagulation profile, and quality of surgical field in intracranial meningioma resection: A prospective randomized, double-blind, placebo-controlled study

2021 ◽  
Vol 12 ◽  
pp. 272
Author(s):  
Gopala K. Ravi ◽  
Nidhi Panda ◽  
Jasmina Ahluwalia ◽  
Rajeev Chauhan ◽  
Navneet Singla ◽  
...  
Keyword(s):  
Placebo Group ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Transfusion Requirement ◽  
Intracranial Meningioma ◽  
Intraoperative Blood Loss ◽  
Double Blind ◽  
Coagulation Profile ◽  
Surgical Field

Background: Resection of intracranial meningioma has been associated with significant blood loss. Providing a clear surgical field and maintaining hemodynamic stability are the major goals of anesthesia during meningioma surgery. Tranexamic acid has been used to reduce blood loss in various neurosurgical settings with limited evidence in literature. A randomized, double-blind, and placebo-controlled trial was conducted to evaluate the efficacy of tranexamic acid on blood loss, coagulation profile, and quality of surgical field during resection of intracranial meningioma. Methods: Thirty patients aged 18–65 years undergoing elective meningioma resection surgery were given either tranexamic acid or placebo (0.9% saline), tranexamic acid at a loading dose of 20 mg/kg, and infusion of 1 mg/kg/h during surgery. The intraoperative blood loss, coagulation profile, and the surgical field using Likert scale were assessed. Results: The patients in tranexamic group had significantly decreased intraoperative blood loss compared to the placebo group (616.42 ± 393.42 ml vs. 1150.02 ± 416.1 ml) (P = 0.02). The quality of the surgical field was better in the tranexamic group (median score 4 vs. 2 on Likert Scale) (P < 0.001). Patients in tranexamic group had an improved coagulation profile and decreased blood transfusion requirement (p=0.016). The blood collected in closed suction drain in 24 h postsurgery was less in the tranexamic acid group compared to placebo group (84.7 ± 50.4 ml vs. 127.6 ± 62.2 ml) (P = 0.047). Conclusion: Tranexamic acid bolus followed by infusion reduces perioperative blood loss by 46.43% and blood transfusion requirement with improved surgical field and coagulation profile in patients undergoing intracranial meningioma resection surgery.

Double-blind, randomized controlled trial of tranexamic acid in minor lumbar spine surgery: no effect on operative time, intraoperative blood loss, or complications

2019 ◽  
Vol 31 (2) ◽  
pp. 194-200 ◽  
Author(s):  
Signe Elmose ◽  
Mikkel Ø. Andersen ◽  
Else Bay Andresen ◽  
Leah Yacat Carreon
Keyword(s):  
Placebo Group ◽  
Lumbar Spine ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Spine Surgery ◽  
Operative Time ◽  
Decompressive Surgery ◽  
Lumbar Spine Surgery ◽  
Intraoperative Blood Loss ◽  
Double Blind

OBJECTIVEThe purpose of this study was to investigate the effect of tranexamic acid (TXA) compared to placebo in low-risk adult patients undergoing elective minor lumbar spine surgery—specifically with respect to operative time, estimated blood loss, and complications. Studies have shown that TXA reduces blood loss during major spine surgery. There have been no previous studies on the effect of TXA in minor lumbar spine surgery in which these variables have been evaluated.METHODSThe authors enrolled patients with ASA grades 1 to 2 scheduled to undergo lumbar decompressive surgery at Middelfart Hospital into a double-blind, randomized, placebo-controlled, parallel-group study. Patients with thromboembolic disease, coagulopathy, hypersensitivity to TXA, or a history of convulsion were excluded. Patients were randomly assigned, in blocks of 10, to one of 2 groups, TXA or placebo. Anticoagulation therapy was discontinued 2–7 days preoperatively. Prior to the incision, patients received either a bolus of TXA (10 mg/kg) or an equivalent volume of saline solution (placebo). Independent t-tests were used to compare differences between the 2 groups, with statistical significance set at p < 0.05.RESULTSOf the 250 patients enrolled, 17 patients were excluded, leaving 233 cases for analysis (117 in the TXA group and 116 in the placebo group). The demographics of the 2 groups were similar, except for a higher proportion of women in the TXA group (TXA 50% vs placebo 32%, p = 0.017). There was no significant between-groups difference in operative time (49.53 ± 18.26 vs 54.74 ± 24.49 minutes for TXA and placebo, respectively; p = 0.108) or intraoperative blood loss (55.87 ± 48.48 vs 69.14 ± 83.47 ml for TXA and placebo, respectively; p = 0.702). Postoperative blood loss measured from drain output was 62% significantly lower in the TXA group (13.03 ± 21.82 ml) than in the placebo group (34.61 ± 44.38 ml) (p < 0.001). There was no significant difference in number of dural lesions or postoperative spinal epidural hematomas, and there were no thromboembolic events.CONCLUSIONSTranexamic acid did not have a statistically significant effect on operative time, intraoperative blood loss, or complications. This study gives no evidence to support the routine use of TXA during minor lumbar decompressive surgery.Clinical trial registration no.: NCT03714360 (clinicaltrials.gov)

scholarly journals Efficacy of tranexamic acid in reducing blood loss, blood and blood products requirements in Cesarian sections for patients with placenta accreta

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Tamer Hamed Ibrahim
Keyword(s):  
Platelet Count ◽  
Placebo Group ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Placenta Accreta ◽  
Controlled Study ◽  
Intraoperative Blood Loss ◽  
Blood Products ◽  
Coagulation Profile ◽  
Significant Difference

Abstract Background Placenta accreta is an obstetric emergency and the main cause of maternal morbidity and mortality due to the associated bleeding and coagulopathy. Tranexamic acid has been widely used to decrease blood loss in trauma patients and patients with postpartum hemorrhage. We aimed at studying the effect of tranexamic acid in reducing blood loss and blood transfusion in patients with placenta accreta. Methods In a double-blinded randomized controlled study, 46 patients were recruited and divided into two groups, Group A is the tranexamic group where patients received 10 mg/kg tranexamic acid after cord clamping and continued on tranexamic infusion 10 mg/kg/h till the end of the surgery. Group B is the placebo where patients received normal saline instead. Primary outcome was the amount of intraoperative blood loss, and other outcomes included the number of blood and blood products transfused intraoperative and in the first 24 h postoperative, the immediate postoperative Hb level, platelet count, and coagulation profile. Data were collected, coded, tabulated, and then analyzed using Minitab® 16.1.0 statistics software package. Variables were presented as mean and standard deviation and analyzed using unpaired t test. Any difference with p value < 0.05 was considered statistically significant. Results Amount of intraoperative blood loss was significantly less in the tranexamic group 2232 ± 1204 ml compared to the placebo group 3405 ± 1193 ml (p value 0.002), and patients in the tranexamic group received less units of packed red blood cells, fresh frozen plasma, and platelets compared to those in the placebo group (4.2 ± 1.9 vs 6.1 ± 2.2 with p value 0.003, 3.4 ± 1.3 vs 4.2 ± 1.2 with P value 0.036 and 4.8 ± 2.1 vs 6.2 ± 2.4 with p value 0.041, respectively). There was no statistically significant difference in the first postoperative Hb level, platelet count, and coagulation profile between the two groups; however, the amount of blood and products transfused in the first 24 h postoperative were significantly less in the tranexamic group Conclusion Tranexamic acid infusion was effective in reducing intraoperative blood loss and intraoperative and postoperative blood and blood products’ transfusion.

scholarly journals Short-term Use of Tranexamic Acid to Reduce Blood Loss in Endoscopic Nasal Surgeries

2011 ◽  
Vol 4 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Sunita Chhapola ◽  
Inita Matta
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Intraoperative Blood Loss ◽  
Nasal Surgery ◽  
Antifibrinolytic Agent ◽  
Surgical Field ◽  
Consequent Improvement ◽  
Selection Of Patients ◽  
Endoscopic Nasal Surgery ◽  
Selection Of

ABSTRACT Objective To evaluate the effect of tranexamic acid, an antifibrinolytic agent, in reduction of surgical hemorrhage during endoscopic nasal surgery. Design Comparative analysis of the use of tranexamic acid in 200 patients undergoing endoscopic nasal surgery and its demonstrable reduction of hemorrhage and improvement of visibility of operative field. Subjects Around 200 patients with varied indications underwent endoscopic nasal surgery; 100 were given tranexamic acid perioperatively and 100 did not receive tranexamic acid and were used as a control. Selection of patients was done on random basis. We used the following parameters to measure intraoperative blood loss: Visibility of field of surgery, weight of blood swabs postoperatively and amount of blood from suction machine. Result Patient who received tranexamic acid showed reduction of blood loss amounting to 72.48% (p < 0.05). This reduction was compared with results published by other authors using various kinds of anesthesia. Conclusions Tranexamic acid is an antifibrinolytic agent which inhibits the action of plasmin. There is also reduction in blood level of D-dimer. It is seen to significantly reduce intraoperative blood loss during endoscopic nasal surgery. Additionally, there seems to be no alteration of coagulation parameters or untoward systemic effects. The consequent improvement in surgical field visibility is of great benefit which is encouraging and should prompt further trials.

The Effect of Deliberate Hypercapnia and Hypocapnia on Intraoperative Blood Loss and Quality of Surgical Field During Functional Endoscopic Sinus Surgery

2007 ◽  
Vol 105 (5) ◽  
pp. 1404-1409 ◽  
Author(s):  
Vladimir Nekhendzy ◽  
Hendrikus J. M. Lemmens ◽  
Winston C. Vaughan ◽  
Edward J. Hepworth ◽  
Alexander G. Chiu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Intraoperative Blood Loss ◽  
Surgical Field

scholarly journals Metoprolol Significantly Improves Visual Clarity and Hemodynamic Parameters during Functional Endoscopic Sinus Surgery

2019 ◽  
Vol 4 (2) ◽  
pp. 1-8
Author(s):  
Ahmed A. Sadek ◽  
Mokhtar Mostafa ◽  
Tarek Abdel-Monem
Keyword(s):  
Blood Loss ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Controlled Study ◽  
Double Blind ◽  
Arterial Blood ◽  
Surgical Field ◽  
Group 2

Background and Objectives: The success of functional endoscopic sinus surgery (FESS) depends on the visual clarity of the surgical field, which is understudied. Controlled hypotension has many advantages for FESS including reduction in blood loss and improved quality of the surgical field. This study determined whether the use of β-blockers as a premedication could improve the operative field in FESS. Methods: Sixty patients aged from 18 to 50 years, undergoing septoplasty and FESS were included in this prospective, randomized, double-blind, placebo-controlled study. Patients were randomly assigned to receive either metoprolol (100 mg, group 1) or a placebo (a vitamin tablet, group 2) 60 min before surgery. Results: The average blood loss and surgery duration were not significantly higher in the placebo group. The surgical field was graded using the Fromme-Boezaart scale, and it was significantly clearer (p < 0.001) in metoprolol group. The mean arterial blood pressure was significantly lower in the metoprolol group after 30 min of induction until the end of surgery (p < 0.001). The heart rate was also significantly lower (p < 0.001) in those who received metoprolol from before induction of anesthesia up to the end of surgery. Conclusion: Metoprolol significantly improves visual clarity and hemodynamics during FESS. We would recommend the use of metoprolol in FESS and septoplasty.

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