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Antifibrinolytic agents in current anaesthetic practice
E Ortmann1, M W Besser, A A Klein
1Department of Anaesthesia and Intensive Care, Papworth Hospital, Papworth Everard, Cambridge CB23 3RE, UK.
British Journal of Anaesthesia
|May 11, 2013
Summary
Antifibrinolytic drugs like tranexamic acid reduce bleeding in major surgery. While generally safe, potential thrombotic complications exist, necessitating careful agent and dose selection for optimal patient outcomes.
Area of Science:
- Anesthesiology
- Pharmacology
- Hematology
Background:
- Antifibrinolytic drugs are widely used in major surgery to manage bleeding.
- Inhibiting the fibrinolytic pathway effectively reduces postoperative and traumatic bleeding.
- Evidence suggests a reduction in perioperative blood transfusions with these agents.
Purpose of the Study:
- To review the current literature on antifibrinolytic drugs.
- To support clinical decision-making in anesthetic practice regarding antifibrinolytic use.
- To discuss the benefits and risks, including thrombosis, associated with antifibrinolytics.
Main Methods:
- Literature review of antifibrinolytic drugs.
- Analysis of evidence for efficacy in reducing bleeding and transfusions.
- Examination of reported complications, particularly thrombosis.
Main Results:
- Inhibition of fibrinolysis consistently reduces bleeding.
- Evidence supports reduced perioperative blood transfusions.
- Thrombotic complications are possible, influenced by drug choice and dosage.
Conclusions:
- Antifibrinolytic drugs are valuable in surgery for bleeding control.
- Tranexamic acid and ε-aminocaproic acid are commonly used agents.
- Careful consideration of individual agents and doses is crucial to balance efficacy and safety.
Keywords:
antifibrinolytic agentscardiac surgical procedureshepatectomyintracranial haemorrhagesliver transplantationorthopaedicspost partum haemorrhagepostoperative haemorrhagewounds and injuriesMore Related Videos
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