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Tranexamic acid given intraoperatively reduces blood loss after total knee replacement: a randomized, controlled
M Veien1, J V Sørensen, F Madsen
1Department of Anesthesiology, and Orthopedic Surgery, Aarhus Amtssygehus, Aarhus University Hospital, Denmark. mveien@dadlnet.dk
Acta Anaesthesiologica Scandinavica
|November 8, 2002
Summary
Tranexamic acid (TXA) significantly reduces blood loss in total knee replacement (TKR) surgery, even with lower blood loss volumes. This study demonstrates TXA
Area of Science:
- Orthopedic Surgery
- Anesthesiology
- Pharmacology
Background:
- Total knee replacement (TKR) surgery is associated with significant blood loss and high rates of allogeneic blood transfusions.
- Previous research indicates Tranexamic acid (TXA) is effective in reducing blood loss by 50% in TKR patients with perioperative losses of 1400-1800 ml.
- The efficacy of TXA in TKR cases with lower blood loss (around 800 ml) remains less understood.
Purpose of the Study:
- To evaluate the effectiveness of Tranexamic acid (TXA) in reducing blood loss during total knee replacement (TKR) surgery when perioperative blood loss is approximately 800 ml.
- To determine if TXA provides benefits in TKR procedures with moderate blood loss.
Main Methods:
- A randomized controlled trial involving 30 consecutive patients undergoing TKR under spinal anesthesia with tourniquet use.
- Patients were allocated to receive either Tranexamic acid (TXA) or a placebo (non-TXA group).
- TXA was administered at a dose of 10 mg/kg at the conclusion of surgery and again 3 hours later. Blood loss was meticulously recorded.
Main Results:
- Total blood loss was significantly lower in the TXA group (409.7 ± 174.9 ml) compared to the non-TXA group (761.7 ± 313.1 ml; P < 0.001).
- No significant differences were observed in coagulation parameters between the groups.
- No patients in the TXA group required blood transfusion, whereas 13% of patients in the non-TXA group did (not significant). No complications were reported in either group.
Conclusions:
- Tranexamic acid (TXA) effectively and significantly reduces blood loss following total knee replacement (TKR) surgery.
- TXA demonstrates benefits even in TKR procedures with moderate perioperative blood loss, not just in cases of extensive hemorrhage.
- The use of TXA in TKR surgery appears safe, with no observed complications or adverse effects on coagulation.