Eoghan T Hurley1, Daren Lim Fat2, Leo Pauzenberger2, Hannan Mullett3. 1. Sports Surgery Clinic, Dublin, Ireland; Royal College of Surgeons in Ireland, Department of Trauma & Orthopaedic Surgery, Dublin, Ireland; National University of Ireland Galway, Galway, Ireland. Electronic address: eoghanhurley@rcsi.ie. 2. Sports Surgery Clinic, Dublin, Ireland. 3. Sports Surgery Clinic, Dublin, Ireland; Royal College of Surgeons in Ireland, Department of Trauma & Orthopaedic Surgery, Dublin, Ireland.
Abstract
BACKGROUND:Tranexamic acid (TXA) is commonly used in orthopedic surgery to reduce perioperative bleeding and the need for transfusion. The purpose of the study was to assess whether TXA could reduce the incidence of postoperative swelling and hematoma formation and pain and opioid use in the early postoperative period following the Latarjet procedure. METHODS: A randomized controlled trial was conducted in 100 patients undergoing open Latarjet surgery for anterior shoulder instability by a single surgeon. Patients were randomized to receive either 1 g TXA or a placebo intravenously preoperatively. Outcomes measured during the perioperative period were (1) intraoperative blood loss, (2) postoperative blood loss (via drain output), (3) postoperative swelling/hematoma formation, (4) visual analog scale (VAS) score, and (5) postoperative opioid use (in morphine milligram equivalents). RESULTS: There was no significant difference in intraoperative blood loss (60.9 vs. 68.9 mL, P = .18). However, there was significantly lower postoperative blood loss with TXA (29.6 vs. 64.9 mL, P < .01). There was a significantly lower rate of painful postoperative swelling (4% vs. 32%, P < .01). Additionally, we found a significantly lower VAS score for pain (1.7 vs. 3.0, P < .01) and significantly less postoperative opioid use (9.4 vs. 22 mg, P < .01) in the TXA group. Postoperative swelling was shown to correlate with increased pain and opioid use (P < .01). CONCLUSION: Our study found that TXA significantly reduced postoperative blood loss, painful postoperative swelling, and hematoma formation and subsequently reduced postoperative pain and opioid use following the Latarjet procedure.
RCT Entities:
BACKGROUND:Tranexamic acid (TXA) is commonly used in orthopedic surgery to reduce perioperative bleeding and the need for transfusion. The purpose of the study was to assess whether TXA could reduce the incidence of postoperative swelling and hematoma formation and pain and opioid use in the early postoperative period following the Latarjet procedure. METHODS: A randomized controlled trial was conducted in 100 patients undergoing open Latarjet surgery for anterior shoulder instability by a single surgeon. Patients were randomized to receive either 1 g TXA or a placebo intravenously preoperatively. Outcomes measured during the perioperative period were (1) intraoperative blood loss, (2) postoperative blood loss (via drain output), (3) postoperative swelling/hematoma formation, (4) visual analog scale (VAS) score, and (5) postoperative opioid use (in morphine milligram equivalents). RESULTS: There was no significant difference in intraoperative blood loss (60.9 vs. 68.9 mL, P = .18). However, there was significantly lower postoperative blood loss with TXA (29.6 vs. 64.9 mL, P < .01). There was a significantly lower rate of painful postoperative swelling (4% vs. 32%, P < .01). Additionally, we found a significantly lower VAS score for pain (1.7 vs. 3.0, P < .01) and significantly less postoperative opioid use (9.4 vs. 22 mg, P < .01) in the TXA group. Postoperative swelling was shown to correlate with increased pain and opioid use (P < .01). CONCLUSION: Our study found that TXA significantly reduced postoperative blood loss, painful postoperative swelling, and hematoma formation and subsequently reduced postoperative pain and opioid use following the Latarjet procedure.
Authors: Jaroslaw Pecold; Mahdi Al-Jeabory; Maciej Krupowies; Ewa Manka; Adam Smereka; Jerzy Robert Ladny; Lukasz Szarpak Journal: J Clin Med Date: 2021-12-23 Impact factor: 4.241
Authors: Eoghan T Hurley; Martin S Davey; Connor Montgomery; Ross O'Doherty; Mohamed Gaafar; Leo Pauzenberger; Hannan Mullett Journal: Orthop J Sports Med Date: 2021-09-08
Authors: Eoghan T Hurley; Martin S Davey; Connor Montgomery; David M Moore; Edward S Mojica; Mohamed Gaafar; Leo Pauzenberger; Laith M Jazrawi; Hannan Mullett Journal: Orthop J Sports Med Date: 2022-02-15