L Pauzenberger 1 , M A Domej 1 , P R Heuberer 1 , M Hexel 1 , A Grieb 1 , B Laky 1 , J Blasl 2 , W Anderl 1 Show Affiliations »
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AIMS: The purpose of the present study was to evaluate the impact of intravenous tranexamic acid on the reduction of blood loss, transfusion rate, and early post-operative clinical outcome in total shoulder arthroplasty . PATIENTS AND METHODS: A randomised, placebo -controlled trial which included 54 patients undergoing unilateral primary stemless anatomical or stemmed reverse total shoulder arthroplasty was undertaken . Patients received either 100 ml saline (placebo , n = 27 ), or 100 ml saline together with 1000 mg of tranexamic acid (TXA , n = 27 ) intravenously prior to skin incision and during wound closure. Peri-operative blood loss via an intra-articular drain was recorded and total blood loss was calculated. The post-operative transfusion rate was documented. Assessment of early clinical parameters included the visual analogue scale for pain (VAS), documentation of haematoma formation and adverse events . RESULTS: Mean peri-operative blood drainage (placebo : 170 ml versus TXA : 50 ml, p = 0.001) and calculated mean total blood loss (placebo : 1248.2 ml versus TXA : 871.0 ml, p = 0.009) were significantly lower in the TXA group. No transfusions were necessary during the study period in either group. Mean VAS for pain significantly decreased from pre-operative (VAS 7) to the early post-operative period (VAS 1.7, p < 0.001). Significant differences regarding mean post-operative pain between placebo (VAS 2.0) and TXA (VAS 1.3) were detected (p = 0.05). The occurrence of haematomas was significantly more frequent in the placebo (59.3%, n = 16) than in the TXA group (25.9%, n = 6, p = 0.027). Whereas only mild haematomas developed in the TXA group, in the placebo group a total of 22.2% (n = 6) developed either moderate or severe haematomas . No adverse events associated with administration of TXA occurred. CONCLUSION: Intravenous administration of TXA successfully reduced mean peri-operative blood drainage, total estimated blood loss, pain during the first post-operative days, and haematoma formation in total shoulder arthroplasty . Cite this article: Bone Joint J 2017;99-B:1073-9. ©2017 The British Editorial Society of Bone & Joint Surgery.
RCT Entities: Population
Interventions
Outcomes
AIMS: The purpose of the present study was to evaluate the impact of intravenous tranexamic acid on the reduction of blood loss , transfusion rate, and early post-operative clinical outcome in total shoulder arthroplasty. PATIENTS AND METHODS: A randomised, placebo-controlled trial which included 54 patients undergoing unilateral primary stemless anatomical or stemmed reverse total shoulder arthroplasty was undertaken. Patients received either 100 ml saline (placebo, n = 27), or 100 ml saline together with 1000 mg of tranexamic acid (TXA , n = 27) intravenously prior to skin incision and during wound closure. Peri-operative blood loss via an intra-articular drain was recorded and total blood loss was calculated. The post-operative transfusion rate was documented. Assessment of early clinical parameters included the visual analogue scale for pain (VAS), documentation of haematoma formation and adverse events. RESULTS: Mean peri-operative blood drainage (placebo: 170 ml versus TXA : 50 ml, p = 0.001) and calculated mean total blood loss (placebo: 1248.2 ml versus TXA : 871.0 ml, p = 0.009) were significantly lower in the TXA group. No transfusions were necessary during the study period in either group. Mean VAS for pain significantly decreased from pre-operative (VAS 7) to the early post-operative period (VAS 1.7, p < 0.001). Significant differences regarding mean post-operative pain between placebo (VAS 2.0) and TXA (VAS 1.3) were detected (p = 0.05). The occurrence of haematomas was significantly more frequent in the placebo (59.3%, n = 16) than in the TXA group (25.9%, n = 6, p = 0.027). Whereas only mild haematomas developed in the TXA group, in the placebo group a total of 22.2% (n = 6) developed either moderate or severe haematomas. No adverse events associated with administration of TXA occurred. CONCLUSION: Intravenous administration of TXA successfully reduced mean peri-operative blood drainage, total estimated blood loss , pain during the first post-operative days, and haematoma formation in total shoulder arthroplasty. Cite this article: Bone Joint J 2017;99-B:1073-9. ©2017 The British Editorial Society of Bone & Joint Surgery.
Entities: Chemical
Disease
Species
Keywords:
Blood loss; Haematocrit; Haemoglobin; Reverse shoulder arthroplasty; Shoulder arthroplasty; Tranexamic acid
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Year: 2017
PMID： 28768785 DOI： 10.1302/0301-620X.99B8.BJJ-2016-1205.R1
Source DB: PubMed Journal: Bone Joint J ISSN： 2049-4394 Impact factor: 5.082