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[Tranexamic acid in orthopedic surgery].

X Aguilera-Roig1, M Jordán-Sales1, L Natera-Cisneros1

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Tranexamic acid (ATX) effectively reduces surgical bleeding in orthopedic procedures, administered intravenously or intra-articularly. While generally safe, its potential thrombotic risk necessitates caution in at-risk patients.

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Area of Science:

  • Pharmacology
  • Surgical Innovation

Context:

  • Perioperative bleeding necessitates blood transfusions, posing risks and increasing healthcare costs.
  • Tranexamic acid (ATX) is a key intervention for mitigating surgical hemorrhage.
  • Orthopedic surgery frequently involves significant blood loss, making hemostatic agents crucial.

Purpose:

  • To evaluate the efficacy and safety of tranexamic acid (ATX) in reducing surgical blood loss.
  • To review established intravenous and intra-articular dosing protocols for ATX in orthopedic settings.
  • To identify potential risks, such as thrombotic effects, associated with ATX administration.

Summary:

  • Tranexamic acid (ATX) demonstrates effectiveness in reducing perioperative blood loss, particularly in orthopedic surgery.
  • Intravenous doses typically range from 10mg/Kg to 2g, while intra-articular doses range from 250mg to 3g.
  • ATX functions as an anti-fibrinolytic agent but carries a contraindication for patients with thrombosis risk due to potential thrombotic effects.

Impact:

  • ATX offers a viable strategy to minimize blood transfusions and associated complications.
  • Optimized ATX administration can lead to reduced patient recovery times and healthcare expenditures.
  • Further research into topical ATX administration is warranted to explore potentially safer application methods.