Evaluation of the use of tranexamic acid in total knee arthroplasty

Almeida, Mariana Diana Chaves de; Albuquerque, Rodrigo Pires e; Palhares, Guilherme Mathias; Almeida, Juliana Patrícia Chaves de; Barretto, João Maurício; Cavanellas, Naasson

doi:10.1016/j.rboe.2018.09.008

Cited by 5 publications

(11 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…9 Almeida et al evaluated the efficacy of tranexamic acid in reducing bleeding in patients undergoing total knee arthroplasty in a triple blinded study prospective randomised controlled study and found that despite their study group having significant lower hemoglobin and hematocrit levels (in the preoperative period) than the control group, the fall in hemoglobin and blood loss was significantly more in the control group. 10 Vijay et al studied the role of tranexamic acid in the context of a pharmacological agent to reduce postoperative blood loss and transfusion requirements in patients undergoing hip and femoral surgeries and concluded that administration of tranexamic acid preoperatively reduced the blood loss in the first 24 hours by highly significant degree in patients undergoing surgeries for hip and femoral fractures. 11 In a review article titled "Tranexamic acid and orthopaedic surgery-the search for the holy grail of blood conservation", Danninger et al have analysed major trials on tranexamic acid use in orthopaedic surgeries and concluded that there is substantial evidence suggesting tranexamic acid is effective in reducing blood loss and the need for blood transfusion in orthopedic surgeries involving joints.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Tranexamic Acid in Total Knee Replacement Surgeries: A Randomized Control Trial

Buddhi¹,

Kapadia²

2018

Journal of Research &Amp; Innovation in Anesthesia

View full text Add to dashboard Cite

Context: Bleeding is of utmost concern in major orthopedic operations like total knee replacement, total hip replacement, and spine surgeries. Strategies to reduce blood loss must be employed to reduce allogeneic blood transfusion. Tranexamic acid (TAX) is an inexpensive synthetic derivative of the amino acid lysine. By attaching to lysine binding sites on plasminogen molecules it forms tranexamic acid-plasmin complex which has weaker fibrinolytic properties than plasmin alone. It also exhibits clot stabilizing and anti-inflammatory properties. When administered to surgical patients it can reduce blood loss and thus decrease transfusion requirements.Aim: This is a study to evaluate the efficacy and safety of tranexamic acid in reducing blood loss and need of postoperative blood transfusions following unilateral total knee replacement surgery in a tertiary care teaching hospital. Materials and methods:Sixty patients,18-70 years, American Society of Anesthesiology (ASA) statuses I and II undergoing unilateral total knee replacement under combined spinal-epidural anesthesia were enrolled in this prospective, randomized, double-blind study. Thirty patients each were randomly assigned to group T (TAX) and group C (control). Group T received intravenous tranexamic acid 10 mg/kg before tourniquet inflation followed by its infusion at 1 mg/kg/hour till skin closure. Group C received a similar amount of normal saline and served as the control group. The demographic data, duration of surgery, intraoperative vital parameters, intraoperative and postoperative blood loss, postoperative hemoglobin levels, quantity of blood transfusion required and a number of patients requiring blood transfusions and risk of the thromboembolic phenomenon were studied. Results:The mean (±SD) total blood loss was lower in the group receiving tranexamic acid (306.96 ± 75.23 mL) than in control group (543 ± 163.36 mL) which amounted to 43.47% less blood loss in the group receiving tranexamic acid. On an average control group required six times more blood transfusion than tranexamic acid group. Conclusion:Use of intravenous tranexamic acid is an effective and safe method to decrease blood loss in surgeries on the bone like total knee replacement.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Tranexamic Acid in Total Knee Replacement Surgeries: A Randomized Control Trial

Buddhi¹,

Kapadia²

2018

Journal of Research &Amp; Innovation in Anesthesia

View full text Add to dashboard Cite

show abstract

“…There was no need to use a control group because the benefit of tranexamic acid during the knee arthroplasty procedure is well-established, so the only doubt was regarding the methodology of its use. 7 8 10 15 16 …”

Section: Methodsmentioning

confidence: 99%

“…Most of these studies have not demonstrated superiority of technique when comparing IA or IV application. 10 11 12 13 14 15 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparação da perda sanguínea com a utilização do ácido tranexâmico endovenoso e intra-articular versus intra-articular isolado em artroplastia primária de joelho

Resch,

Lemos,

Santos

et al. 2023

Rev Bras Ortop (Sao Paulo)

View full text Add to dashboard Cite

Resumo Objetivo O objetivo desse trabalho é comparar a perda sanguínea durante a artroplastia primária de joelho, com a utilização do ácido tranexâmico endovenoso e intra-articular (EV + IA) versus intra-articular (IA) isolado. Métodos Trata-se de um ensaio clínico randomizado, duplo cego. Pacientes com indicação de artroplastia total primária de joelho foram captados em clínica especializada, onde foram operados pelo mesmo cirurgião, utilizando sempre a mesma técnica cirúrgica. Trinta pacientes foram alocados no grupo ácido tranexâmico EV + IA e 30 pacientes, no grupo IA, conforme randomização. Foi comparada a perda sanguínea através dos níveis de hemoglobina, hematócrito, volume do dreno e estimativa da perda sanguínea (EBL) (cálculo de Gross e Nadler). Resultados Após a coleta, foram analisados os dados de 40 pacientes, sendo 22 do grupo IA isolado e 18 do grupo EV + IA. Ocorreram 20 perdas por erro de coleta. Entre os grupos IA e EV + IA, não ocorreram diferenças significativas em 24 horas entre os níveis de hemoglobina (10,56 vs. 10,65 g/dL; F1,39 = 0,63, p = 0,429), eritrócito (3,63 vs. 3,73 milhões/mm3; F1,39 = 0,90, p = 0,346), hematócrito (32,14 vs. 32,60%; F1,39 = 1,39; p = 0,240), volume de dreno (197,0 vs. 173,6 mL; F1,39 = 3,38; p = 0,069) e estimativa de perda sanguínea (EBL) (1.002,5 vs. 980,1; F1,39 = 0,09; p = 0,770). O mesmo ocorreu nas comparações realizadas 48 horas pós-operatório. O tempo foi fator significativo para a mudança de todas as variáveis de desfecho. Porém, o tratamento não modificou o efeito do tempo nesses desfechos. Nenhum indivíduo apresentou qualquer evento tromboembólico durante o período do trabalho. Conclusões O uso do ácido tranexâmico EV + IA não demonstrou vantagem em redução de perda sanguínea quando comparado ao uso de ácido tranexâmico IA isolado nas artroplastias primárias de joelho. Esta técnica demonstrou-se segura, visto que nenhum evento trombo-embólico ocorreu durante o desenvolvimento do trabalho.

show abstract

“…3 x 0,356 + peso (Kg) x 0,33 + 0,183 Parecer Consubstanciado do CEP O estudo foi dividido em 2 subprojetos, onde no primeiro focamos na avaliação clínica e perda sanguínea e no segundo no comprometimento muscular causado pela isquemia induzida pelo torniquete.…”

unclassified

Artroplastia total do joelho com ou sem isquemia: o uso otimizado do torniquete em um estudo comparativo, prospectivo e randomizado

Pavão¹

View full text Add to dashboard Cite

Evaluation of the use of tranexamic acid in total knee arthroplasty

Cited by 5 publications

References 29 publications

Efficacy and Safety of Tranexamic Acid in Total Knee Replacement Surgeries: A Randomized Control Trial

Efficacy and Safety of Tranexamic Acid in Total Knee Replacement Surgeries: A Randomized Control Trial

Comparação da perda sanguínea com a utilização do ácido tranexâmico endovenoso e intra-articular versus intra-articular isolado em artroplastia primária de joelho

Artroplastia total do joelho com ou sem isquemia: o uso otimizado do torniquete em um estudo comparativo, prospectivo e randomizado

Contact Info

Product

Resources

About