Jinqian Liang1, Hongzhe Liu2, Xiangwang Huang3, Wei Xiong4, Hong Zhao5, Sooyong Chua6, Zheng Li7. 1. Department of Orthorpaedic Surgery, Peking Union Medical College Hospital, China. Electronic address: string218@126.com. 2. Department of Spine Union, Hunan Provincial People's Hospital, China. Electronic address: liuhongzhe7890@126.com. 3. Department of Spine Union, Hunan Provincial People's Hospital, China. Electronic address: huangxiangwang@126.com. 4. Department of Spine Union, Hunan Provincial People's Hospital, China. Electronic address: xiongwei@126.com. 5. Department of Orthorpaedic Surgery, Peking Union Medical College Hospital, China. Electronic address: zhaohongpumch@126.com. 6. Department of Orthorpaedic Surgery, Changi General Hospital, Singapore. 7. Department of Orthorpaedic Surgery, Peking Union Medical College Hospital, China. Electronic address: Lizheng1984@126.com.
Abstract
OBJECTIVES: This paper aims to determine whether the use of Tranexemic Acid (TXA) - soaked absorbable gelatin sponge could more effectively reduce post-operative blood loss and blood transfusion requirements among low-risk adult patients undergoing lumbar spine surgery. METHODS: A total of 90 consecutive patients undergoing surgery for multilevel posterior lumbar degenerative procedures were prospectively randomized into one of three groups: - TXA Soaked Gelfoam group, absorbable gelatin sponge group or control group. Demographic distribution, total drain output, blood transfusion requirement, length of hospital stay, the number of readmissions, and postoperative complications were analyzed. RESULTS: In the TXA Soaked Gelfoam, Gelfoam, and control groups, the respective hemovac drainage at the first 8h postoperatively was 81.06±61.21, 166.73±76.76, and 155.67±92.94ml respectively. The second 8h period drainage for the same groups postoperatively was 46.67±40.09, 55.10±43.43, and 82.50±56.67ml and 23.73±25.56, 32.43±25.81 and 44.20±32.44ml for the third 8h period postoperatively. The duration of the post-operative drain left in the TXA Soaked Gelfoam group was significantly shorter than the Gelfoam and control groups (p=0.019 and 0.000, respectively). The TXA Soaked Gelfoam and Gelfoam also had a significantly shorter hospital stay than the control group (p=0.014, and 0.036, respectively). No patient developed adverse reactions attributable to the tranexamic acid soaked absorbable gelatin sponge. CONCLUSIONS:TXA-soaked absorbable gelatin sponge is a safe, effective treatment for reduction of post-operative blood loss and blood transfusions among low-risk adult patients undergoing lumbar spine surgery.
RCT Entities:
OBJECTIVES: This paper aims to determine whether the use of Tranexemic Acid (TXA) - soaked absorbable gelatin sponge could more effectively reduce post-operative blood loss and blood transfusion requirements among low-risk adult patients undergoing lumbar spine surgery. METHODS: A total of 90 consecutive patients undergoing surgery for multilevel posterior lumbar degenerative procedures were prospectively randomized into one of three groups: - TXA Soaked Gelfoam group, absorbable gelatin sponge group or control group. Demographic distribution, total drain output, blood transfusion requirement, length of hospital stay, the number of readmissions, and postoperative complications were analyzed. RESULTS: In the TXA Soaked Gelfoam, Gelfoam, and control groups, the respective hemovac drainage at the first 8h postoperatively was 81.06±61.21, 166.73±76.76, and 155.67±92.94ml respectively. The second 8h period drainage for the same groups postoperatively was 46.67±40.09, 55.10±43.43, and 82.50±56.67ml and 23.73±25.56, 32.43±25.81 and 44.20±32.44ml for the third 8h period postoperatively. The duration of the post-operative drain left in the TXA Soaked Gelfoam group was significantly shorter than the Gelfoam and control groups (p=0.019 and 0.000, respectively). The TXA Soaked Gelfoam and Gelfoam also had a significantly shorter hospital stay than the control group (p=0.014, and 0.036, respectively). No patient developed adverse reactions attributable to the tranexamic acid soaked absorbable gelatin sponge. CONCLUSIONS:TXA-soaked absorbable gelatin sponge is a safe, effective treatment for reduction of post-operative blood loss and blood transfusions among low-risk adult patients undergoing lumbar spine surgery.
Authors: Nida Fatima; Megan E Barra; Russel Joseph Roberts; Elie Massaad; Muhamed Hadzipasic; Ganesh M Shankar; John H Shin Journal: Neurosurg Rev Date: 2020-01-14 Impact factor: 3.042