Marcin Jaszczyk1, Dariusz Kozerawski1, Łukasz Kołodziej2, Arkadiusz Kazimierczak3, Patryk Sarnecki1, Łukasz Sieczka2. 1. Department V of Trauma and Orthopaedic Surgery, A. Sokołowski Specialist Hospital, Szczecin Zdunowo, Poland. 2. University and Hospital Department of Orthopaedics, Traumatology, and Oncology of the Musculoskeletal System, Pomeranian Medical University, Szczecin, Poland. 3. Department of Vascular Surgery, General Surgery, and Angiology, Pomeranian Medical University, Szczecin, Poland.
Abstract
BACKGROUND: The aim of the study was to assess the effect of a single intravenous dose of tranexamic acid administered before surgery in patients undergoing total cementless hip arthroplasty on: intra-, post-, and perioperative blood lost, the number of patients requiring transfusion, the incidence of thromboembolic complications Material and methods. The study enrolled 124 patients, who were randomly divided into two groups. The experimental group (61 patients) received an intravenous dose of 15 mg/kg of tranexamic acid 20 minutes before the skin incision, while the control group (63 patients) did not receive this drug. We analysed intraoperative blood loss (volume of blood in the aspirator), postoperative blood loss (volume of blood drained), total perioperative blood loss, and the number of patients requiring transfusion as well as the number of thromboembolic complications in both groups. RESULTS: In the experimental group, mean intraoperative blood loss was significantly lower at 216 ml compared to 408.5 ml in the control group (p=0.00421). Postoperative blood loss on the first postoperative day was also lower in the experimental group (246.3 ml) as compared with the control group (358 ml, p=0.000097). Estimated perioperative blood loss in the experimental group was lower as well, reaching 779 ml, vs. 1315.5 ml in the control group (p=0.00567). The percentage of patients requiring transfusion in the experimental group (3.27%) was significantly lower than in the control group (22.22%) (p=0.00166). The use of tranexamic acid did not influence the number of thromboembolic complications (p=0.3075). CONCLUSIONS: 1. The administration of 15 mg/kg of tranexamic acid 20 minutes before surgery decreases the need for postoperative transfusion of allogeneic blood due to a significant reduction in intra-, post-, and perioperative blood loss. 2. Seeing that this method does not increase the number of thromboembolic complications and is simple and inexpensive, it should be considered worthy of recommendation in total cementless hip arthroplasty.
RCT Entities:
BACKGROUND: The aim of the study was to assess the effect of a single intravenous dose of tranexamic acid administered before surgery in patients undergoing total cementless hip arthroplasty on: intra-, post-, and perioperative blood lost, the number of patients requiring transfusion, the incidence of thromboembolic complications Material and methods. The study enrolled 124 patients, who were randomly divided into two groups. The experimental group (61 patients) received an intravenous dose of 15 mg/kg of tranexamic acid 20 minutes before the skin incision, while the control group (63 patients) did not receive this drug. We analysed intraoperative blood loss (volume of blood in the aspirator), postoperative blood loss (volume of blood drained), total perioperative blood loss, and the number of patients requiring transfusion as well as the number of thromboembolic complications in both groups. RESULTS: In the experimental group, mean intraoperative blood loss was significantly lower at 216 ml compared to 408.5 ml in the control group (p=0.00421). Postoperative blood loss on the first postoperative day was also lower in the experimental group (246.3 ml) as compared with the control group (358 ml, p=0.000097). Estimated perioperative blood loss in the experimental group was lower as well, reaching 779 ml, vs. 1315.5 ml in the control group (p=0.00567). The percentage of patients requiring transfusion in the experimental group (3.27%) was significantly lower than in the control group (22.22%) (p=0.00166). The use of tranexamic acid did not influence the number of thromboembolic complications (p=0.3075). CONCLUSIONS: 1. The administration of 15 mg/kg of tranexamic acid 20 minutes before surgery decreases the need for postoperative transfusion of allogeneic blood due to a significant reduction in intra-, post-, and perioperative blood loss. 2. Seeing that this method does not increase the number of thromboembolic complications and is simple and inexpensive, it should be considered worthy of recommendation in total cementless hip arthroplasty.