Comparing Efficacy of Three Methods of Tranexamic Acid Administration in Reducing Hemoglobin Drop Following Total Knee Arthroplasty

Sarzaeem, Mohammad Mahdi; Razi, Mohammad; Kazemian, Gholamhosein; Moghaddam, Mohammad Emami; Rasi, Alireza Manafi; Karimi, Meysam

doi:10.1016/j.arth.2014.02.031

Cited by 115 publications

(92 citation statements)

References 24 publications

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“…In our study we compared the fall in hemoglobin post-operatively compared to pre-operative hemoglobin and found a significantly higher hemoglobin post-operatively ( Sarzaeem MM et al found that intravenous route was more effective in reducing the post-operative hemoglobin drop when compared to topical or intra-articular route (24).All these studies state that use Tranexamic Acid intravenously significantly leads to higher post-operative hemoglobin compared to placebo which is consistent with our study. A minimum of two dose regimen should be administered to significantly reduce blood loss volume.…”

Section: Hemoglobinsupporting

confidence: 81%

Evaluate The Role of Tranexamic Acid In Joint Replacement Surgeries

Yadav¹,

Chauhan²,

Peshin³

2017

IOSR JDMS

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Section: Hemoglobinsupporting

confidence: 81%

Evaluate The Role of Tranexamic Acid In Joint Replacement Surgeries

Yadav¹,

Chauhan²,

Peshin³

2017

IOSR JDMS

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“…[14][15][16][17] However, its route of administration is still a matter of debate. [18][19][20][21][22][23][24][25] Intravenous (IV) route of administration can lead to various systemic complications such as deep vein thrombosis (DVT)/pulmonary embolism (PE). [26][27][28][29] Topical application of TXA has been proposed to decrease these adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Topical versus intravenous tranexamic acid in total knee arthroplasty

Meena

Benazzo

Dwivedi

et al. 2017

J Orthop Surg (Hong Kong)

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Purpose: The aim of this meta-analysis is to examine the efficacy and safety of intra-articular tranexamic acid (TXA) when compared to intravenous (IV) route. Methods: The literature search was conducted using PubMed, Cochrane Library, MEDLINE, EMBASE and China National Knowledge Infrastructure (CNKI). All randomized controlled trials evaluating the effectiveness of topical route and IV route of TXA administration were included. Results: Eight randomized clinical trials comprising of 857 patients were included in this analysis. We found no statistically significant difference in terms of total blood loss, drain output, transfusion requirement, thromboembolic complication, tourniquet time and surgical duration. Conclusion: Topical TXA has a similar efficacy to IV-TXA in reducing total blood loss, drain output, transfusion rate and haemoglobin drop without any increase in thromboembolic complications.

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“…Studies that directly compare the efficacy of local and IV form of TA administration bring conflicting conclusions related to the efficacy of reduction of blood loss. While the conclusions of studies by Hamlin et al [20] and Seoa et al [21] have pointed out the higher efficacy of intra-articular administration of TA, Sarzaeema et al [22] have found significantly lower incidence of administered BTs in patients with IV administration of TA. The results of our study confirm the efficacy of both forms of TA administration to reduce the number of required BTs.…”

Section: Discussionmentioning

confidence: 89%

Comparison of intravenous and intra-articular tranexamic acid in reducing blood loss in primary total knee replacement

Lacko¹

2017

Eklem Hastalik Cerrahisi

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ÖZAmaç: Bu çalışmada primer tek taraflı çimentolu total diz ameliyatı sırasında kan kaybını ve ameliyat sonrası erken komplikasyonların derecesini azaltmada intraartiküler traneksamik asit (TA) ve intravenöz (İV) TA'nın etkinliği ve güvenilirliği karşılaştırıldı. Hastalar ve yöntemler: Bu prospektif randomize çalışmaya diz osteoartriti olup tek taraflı çimentolu total diz replasmanı ameliyatı geçiren 90 hasta (36 erkek, 54 kadın; ort. yaş 68,7 yıl; dağılım 47-82 yıl) dahil edildi. Hastalar üç gruba randomize edildi: grup 1'e ameliyattan 20 dakika önce ve ilk dozdan üç saat sonra İV yolla TA (doz 10 mg/kg) verildi, grup 2'ye cerrahi alana lokal olarak (intraartiküler) TA (doz 3 g) verildi ve grup 3'e TA verilmedi. Ameliyat sırasındaki kan kaybı, ameliyat sonrası 24 saatte boşaltılan kan miktarı, toplam kan kaybı, hemoglobin ve hematokrit düzeylerindeki azalma ve kan transfüzyonu miktarı ölçüldü. Bulgular: Hastaların ameliyat öncesi demografik verilerinde gruplar arasında farklılık yoktu. Traneksamik asitin lokal veya İV uygulaması kan transfüzyonu sayısını ve drenajdaki kan kaybını anlamlı şekilde azalttı. Traneksamik asitin İV uygulaması istatistiksel olarak anlamlı daha yüksek hemoglobin ve hematokrit düzeyleri ve daha düşük ameliyat sonrası toplam kan kaybı ile ilişkiliydi. Grupların hiçbirinde ciddi komplikasyon gözlemlenmedi. Sonuç: Kan transfüzyonu sayısını azaltmada intraartiküler TA İV rejim kadar etkili idi. Ancak TA'nın İV uygulaması daha düşük toplam kan kaybı ile ilişkiliydi. Bulgularımız total diz replasmanı sırasında TA'nın İV uygulamasının intraartiküler uygulamaya göre daha üstün olduğunu gösterdi.Anahtar sözcükler: Artroplasti; diz; replasman; traneksamik asit. ABSTRACT Objectives:This study aims to compare the efficacy and safety of intra-articular tranexamic acid (TA) versus intravenous (IV) TA in the reduction of perioperative blood loss and the degree of early postoperative complications associated with primary unilateral cemented total knee replacement. Patients and methods: This prospective randomized study included 90 patients (36 males, 54 females; mean age 68.7 years; range 47 to 82 years) with knee osteoarthritis undergoing a unilateral cemented total knee replacement. Patients were randomized into three groups: group 1 received TA intravenously (dose 10 mg/kg) 20 minutes preoperatively and three hours after first dose, group 2 received TA (dose 3 g) locally (intra-articular) into surgical site, and group 3 did not receive TA. We measured perioperative blood loss, volume of drained blood in 24 hours postoperatively, overall blood loss, decrease in hemoglobin and hematocrit levels, and amount of blood transfusion. Results: There were no differences between the groups in terms of patient preoperative demographics. Local or IV administration of TA significantly reduced the number of blood transfusions and blood losses in drainage. Intravenous application of TA was associated with statistically significantly higher hemoglobin and hematocrit levels and lower overall postoperative blood losse...

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Comparing Efficacy of Three Methods of Tranexamic Acid Administration in Reducing Hemoglobin Drop Following Total Knee Arthroplasty

Cited by 115 publications

References 24 publications

Evaluate The Role of Tranexamic Acid In Joint Replacement Surgeries

Evaluate The Role of Tranexamic Acid In Joint Replacement Surgeries

Topical versus intravenous tranexamic acid in total knee arthroplasty

Comparison of intravenous and intra-articular tranexamic acid in reducing blood loss in primary total knee replacement

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