1.
The perioperative efficacy and safety of tranexamic acid in adolescent idiopathic scoliosis
Zhong J, Cao K, Wang B, Zhou X, Lin N, Lu H
World neurosurgery. 2019
Abstract
OBJECTIVE To evaluate the efficacy and safety of tranexamic acid (TXA) in patients with adolescent idiopathic scoliosis (AIS) undergoing correction surgery. METHODS A literature search of PubMed, Embase, and Cochrane Library was performed to identify studies published from inception to February 2019. After study selection and data extraction, statistical analysis was performed with RevMan 5.3. The odds ratios (ORs) and weight mean differences (WMDs) with 95% confidence intervals (CIs) for all available clinical outcomes were analyzed using fixed or random effects models. RESULTS A total of 12 studies involving 2500 patients were included. Intravenous TXA use was associated with significantly fewer patient received blood transfusion [OR, 0.12; 95%CI, 0.06 to 0.22; P < 0.001], less intraoperative estimated blood loss (EBL) [WMD, -470.07; 95%CI, -645.23 to -294.90; P < 0.001], less intraoperative EBL per segment [WMD, -27.40; 95%CI, -32.80 to -22.00; P < 0.001], less cell salvage blood transfusion [WMD, -106.02; 95%CI, -170.84 to -41.20; P = 0.001], and shorter surgical time [WMD, -26.18; 95%CI, -46.91 to -5.46; P = 0.010]. No significant difference was found in postoperative hemoglobin [WMD, 0.39; 95%CI, -0.07 to 0.86; P = 0.100] and hemoglobin change [WMD, -0.92; 95%CI, -2.90 to 1.07; P = 0.360] between the TXA group and the control group. No renal, thromboembolic, or other major complications associated with TXA were noted in included studies. CONCLUSIONS TXA was effective in reducing surgical time, intraoperative EBL and blood transfusion without increasing complications in patients undergoing correction surgery for AIS. However, TXA have no influence on postoperative hemoglobin and hemoglobin change.
2.
Effectiveness and safety of tranexamic acid for total knee arthroplasty: a prospective randomized controlled trial
Shen PF, Hou WL, Chen JB, Wang B, Qu YX
Medical Science Monitor. 2015;21:576-81.
Abstract
Background Total knee arthroplasty (TKA) is associated with significant perioperative blood loss and need for transfusion. This study aimed to evaluate the effectiveness and safety of tranexamic acid (TXA) to reduce perioperative blood loss in patients receiving TKA. Material and Methods A total of 92 patients who accepted unilateral TKA from May 2012 to May 2013 randomly received either 15 mg/kg TXA in 100 mL normal saline solution (TXA group, n=46) or the same amount of normal saline solution (placebo group, n=46) at 15 min before the tourniquet was loosened. The following data were recorded: intraoperative blood loss; post-operative drainage at 12 h; total drainage amount; hidden blood loss; total blood loss; transfusion volumes; number of transfusions; post-operative hemoglobin at 1, 3, and 5 days; D-dimer; number of lower limb ecchymoses; and deep vein thrombosis (DVT). Results A total of 81 patients were available for analysis (TXA group, n=41; placebo group, n=40). Post-operative12-h drainage, post-operative 24-h D-dimer values, total drainage volume, hidden blood loss, total blood loss, and the rate of postoperative ecchymosis were lower in the TXA group than in the placebo group (p<0.05). The post-operative 3-day Hgb was higher in the TXA group than in the placebo group (p=0.000). The rate of transfusion and DVT was similar in both groups (n.s.). Conclusions Perioperative blood loss could be reduced after TKA by intravenously injecting 15 mg/kg TXA at 15 min before the tourniquet was loosened. The application of TXA is not associated with increased risk of DVT.
3.
Efficacy and safety evaluation of intra-articular injection of tranexamic acid in total knee arthroplasty operation with temporarily drainage close
Wang G, Wang D, Wang B, Lin Y, Sun S
International journal of clinical and experimental medicine. 2015;8((8)):14328-34.
Abstract
OBJECTIVE To investigate the efficacy and safety of tranexamic acid (TXA) injection during primary total knee arthroplasty (TKA) for reducing postoperative hemorrhage. METHODS 100 cases of patients admitted to our hospital and underwent primary unilateral TKA from January 2012 to December 2014 were enrolled in this study and they were divided randomly into two groups. For the TXA group, 1 g TXA was dissolved in 50 ml 0.9% sodium chloride solution and injected after prosthesis implantation but before cavity close. Conventional drainage clamping was carried for 4 h and the drainage tube was removed 48 h postoperative. For the control group, similar measures were taken except for that no TXA was dissolved in 0.9% sodium chloride solution. Postoperative hemoglobin, blood coagulation index, total blood loss volume, drainage volume, blood transfusion rate and lower extremity deep vein thrombosis (DVT) rate in both groups were observed and the efficacy and safety of this surgical treatment were evaluated. RESULTS There were no significant differences in operation time, postoperative platelet and APPT, D-dimer, lower limb venous thrombosis incidence rate 1 week after operation between the two groups. Postoperative drainage volume, hemoglobin, total blood loss and blood transfusion rate in the TXA group were significantly lower than those of the control group. Ecchymosis of lower extremity peripheral incision and its surroundings was significantly milder than that of the control group. CONCLUSION Intraoperative intra-articular injection of TXA in TKA can significantly reduce the initial postoperative hemorrhage and blood transfusion rate at the early stage after operation.