The prophylactic role of tranexamic acid to reduce blood loss during radical surgery: A prospective study

Abstract

Background:The radical surgical procedures are associated with perioperative blood loss. This study was aimed to evaluate the clinical efficacy and safety of tranexamic acid in reducing perioperative blood loss in patients undergoing radical surgery.Materials and Methods:Sixty ASA class I and II adult consented female patients, scheduled for elective radical surgery and met the inclusion criterion, were blindly randomized into two groups to receive either intravenous 1 g tranexamic acid 20 min before skin incision or an equivalent volume of normal saline as placebo (P). All patient's total blood loss was measured and recorded perioperatively at the 12thh postoperatively. The preoperative and postoperative hemoglobin, hematocrit values, serum creatinine, activated thromboplastin time, prothombin time, thrombocyte count, fibrinogen, D-dimer, and symptoms of pulmonary embolism were comparatively evaluated.Results:The tranexamic acid significantly reduced the quantity of total blood loss, 576 ± 53 mL in study group as compared to 823 ± 74 mL in the control group (P<0.01). Postoperatively hematocrit values were higher in the tranexamic acid group. The coagulation profile did not differ between the groups, but D-dimer concentrations were increased in the control group. No complications or adverse effects were reported in the either group.Conclusion:The prophylactic administration of tranexamic acid has effectively reduced theblood loss and transfusion needs during radical surgery without any adverse effects or complication of thrombosis.

Does the preoperative administration of tranexamic acid reduce perioperative blood loss and transfusion requirements after head neck cancer surgery? A randomized, controlled trial

“…Gupta et al . [ 28 ] in their study on modified radical mastectomy and Wertheim's operation found that 1 g IV TA administered prophylactically 20 min before skin incision reduced the blood loss and transfusion requirement without any side effect.…”

Efficacy of tranexamic acid for the prevention of bleeding in patients with von Willebrand disease and Glanzmann thrombasthenia: a controlled, before and after trial

“…A work by Smit proved that perioperative administration of TXA was associated with reduction in blood loss in patients who had total knee arthroplasty without any history of haematological disorders . It was further supported by Gupta's work which showed that IV administration of TXA could significantly reduce blood loss in radical surgeries . CRASH‐2 clinical trial proved that early administration of TXA can significantly reduce mortality in trauma patients although it has no effect on transfusion requirements .…”

Effectiveness of tranexamic acid for decreasing bleeding in prostate surgery: a systematic review and meta-analysis

“…Different studies have demonstrated that the use of tranexamic acid does not increase the incidence of thromboembolic events [ 11 , 15 ]. In this study, it was not possible to evaluate this outcome because data on this variable were found in only one publication and there were no significant differences.…”