Combined Application of Tranexamic Acid and Thrombelastography in Pediatric Epilepsy Surgery

Abstract

Background: Pediatric patients undergoing epilepsy surgeries are under high risks of bleeding, hemodynamic instability and complications related to transfusions. This study aimed to investigate whether combined application of tranexamic acid (TXA) and thrombelastography (TEG) in pediatric epilepsy surgery can decrease blood loss, transfusion requirements and post-operation complications. Methods: Thirty-two pediatric patients undergoing elective epilepsy surgery were randomized into two groups. Group T (Group T=Group Treatment, n=16) was given a loading dose of 10 mg/kg TXA in 15 minutes and then maintained at the speed of 5 mg/kg/h, while Group C (Group C=Group Control, n=16) was given the same dosage of normal saline. TEG tests were performed at the beginning of surgery (T1), opening the dura mater (T2), closing the dura mater (T3) and the end of surgery (T4) in both groups. In Group T, transfusion decision was made according to TEG results; while in Group C, it was made by anesthetist's experience without knowing the TEG results.