Effect of carbazochrome sodium sulfonate combined with tranexamic acid on blood loss and inflammatory response in patients undergoing total hip arthroplasty

Abstract

Aims The purpose of this study was to examine the efficacy and safety of carbazochrome sodium sulfonate (CSS) combined with tranexamic acid (TXA) on blood loss and inflammatory responses after primary total hip arthroplasty (THA), and to investigate the influence of different administration methods of CSS on perioperative blood loss during THA. Methods This study is a randomized controlled trial involving 200 patients undergoing primary unilateral THA. A total of 200 patients treated with intravenous TXA were randomly assigned to group A (combined intravenous and topical CSS), group B (topical CSS), group C (intravenous CSS), or group D (placebo). Results Mean total blood loss (TBL) in groups A (605.0 ml (SD 235.9)), B (790.9 ml (SD 280.7)), and C (844.8 ml (SD 248.1)) were lower than in group D (1,064.9 ml (SD 318.3), p < 0.001). We also found that compared with group D, biomarker level of inflammation, transfusion rate, pain score, and hip range of motion at discharge in groups A, B, and C were significantly improved. There were no differences among the four groups in terms of intraoperative blood loss (IBL), intramuscular venous thrombosis (IMVT), and length of hospital stay (LOS). Conclusion The combined application of CSS and TXA is more effective than TXA alone in reducing perioperative blood loss and transfusion rates, inflammatory response, and postoperative hip pain, results in better early hip flexion following THA, and did not increase the associated venous thromboembolism (VTE) events. Intravenous combined with topical injection of CSS was superior to intravenous or topical injection of CSS alone in reducing perioperative blood loss. Cite this article: Bone Joint Res 2021;10(6):354–362.

Using tranexamic acid for an additional 24 hours postoperatively in hip and knee arthroplasty saves money: a cost analysis from the TRAC-24 randomized control trial

“…These include reduced blood loss in the peri-and postoperative periods. [3][4][5][6] The advantages of this include a higher haemoglobin level postoperatively, which is especially important in older patients. 7,21 This has been shown to have a significant effect on patient outcomes including quality of life scores postoperatively and readmission rate.…”

“…1 Tranexamic acid (TXA) is now commonly used in THA and TKA to reduce blood loss in low-risk patient groups, with strong evidence in the literature to support its use. [2][3][4][5][6][7] Highrisk patients such as those with previous venous thromboembolism (VTE), myocardial infarction (MI), and cerebrovascular accidents (CVAs) have been excluded from orthopaedic trials to date. 8 Various dosing regimens have also been described, with support in the literature for extending oral or intravenous (IV doses of TXA to reduce blood loss further and potentially improve patient outcomes.…”