Related Experiment Video
Updated: Aug 18, 2026
Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review
Published on: March 27, 2026
Tranexamic acid reduces intraoperative blood loss in pediatric patients undergoing scoliosis surgery
Navil F Sethna1, David Zurakowski, Robert M Brustowicz
1Department of Anesthesiology, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA. navil.sethna@childrens.harvard.edu
Insights
Tranexamic acid significantly reduced blood loss by 41% in pediatric scoliosis surgery. This antifibrinolytic agent is effective in minimizing surgical bleeding in children undergoing spinal fusion.
Area of Science:
- Pediatric Orthopedic Surgery
- Anesthesiology
- Pharmacology
Background:
- Pediatric scoliosis surgery often involves significant blood loss.
- Accelerated fibrinolysis is a contributing factor to excessive bleeding.
- Tranexamic acid is investigated for its potential to mitigate bleeding.
Purpose of the Study:
- To evaluate the efficacy of tranexamic acid in reducing blood loss during pediatric scoliosis surgery.
- To assess the impact of tranexamic acid on transfusion requirements.
Main Methods:
- A randomized controlled trial involving 44 patients undergoing spinal fusion.
- Patients received either tranexamic acid or a saline placebo.
- Blood loss, transfusion volumes, coagulation, and complications were monitored.
Main Results:
- Tranexamic acid reduced blood loss by 41% compared to placebo (1,230 vs. 2,085 ml).
- No significant difference in blood transfusion requirements between groups.
- Tranexamic acid administration predicted lower blood loss.
Conclusions:
- Intraoperative tranexamic acid effectively reduces blood loss in pediatric spinal fusion for scoliosis.
- The drug was well-tolerated with no observed adverse effects.
Background:
Excessive bleeding often occurs during pediatric scoliosis surgery and is attributed to numerous factors, including accelerated fibrinolysis. The authors hypothesized that administration of tranexamic acid would reduce bleeding and transfusion requirements during scoliosis surgery.
Methods:
Forty-four patients scheduled to undergo elective spinal fusion were randomly assigned to receive either 100 mg/kg tranexamic acid before incision followed by an infusion of 10 mg . kg . h during surgery (tranexamic acid group) or 0.9% saline (placebo group). General anesthesia was administered according to a standard protocol. Blood loss, transfusion requirements, coagulation parameters, and complications were assessed.
Results:
In the tranexamic acid group, blood loss was reduced by 41% compared with placebo (1,230 +/- 535 vs. 2,085 +/- 1,188 ml; P < 0.01). The amount of blood transfused did not differ between groups (615 +/- 460 vs. 940 +/- 718 ml; P = 0.08). Administration of tranexamic acid was a multivariate predictor of blood loss, as was American Society of Anesthesiologists physical status and preoperative platelet count. No apparent adverse drug effects occurred in any patient.
Conclusion:
Intraoperative administration of tranexamic acid significantly reduces blood loss during spinal surgery in children with scoliosis.