Tranexamic acid in control of primary hemorrhage during transurethral prostatectomy

Rannikko, Antti; Pétas, Anssi; Taari, Kimmo

doi:10.1016/j.urology.2004.07.008

Cited by 88 publications

(72 citation statements)

References 30 publications

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“…Other studies documented the effectiveness of tranexamic acid in the presence of fibrinolysis during cardiac surgery and cardiopulmonary bypass [24,25], neurosurgery [26,27], prostatectomy [28,29], and other surgeries, while there are no studies measured the fibrinolytic activity during tonsillectomy. This means that the tranexamic acid may be more effective to decrease the bleeding due to fibrinolysis, while it is not effective in other surgery without fibrinolysis.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the effect of tranexamic acid on perioperative bleeding in pediatric patients undergoing tonsillectomy

Soliman

Alshehri²

2015

Egyptian Journal of Anaesthesia

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Background: Tonsillectomy is one of the most common surgery in pediatric and bleeding is one of the most serious complications related to tonsillectomy. Tranexamic acid is a plasminogen inhibitor which has been successfully used to control bleeding in a variety of surgeries. Aim: The aim of the present study was to assess the effect of tranexamic acid on bleeding in pediatric patients undergoing elective tonsillectomy. Materials and methods: The present study included 225 patients classified into three groups: (n = 75): Group A: The tranexamic acid was given after induction intravenously as 15 mg/kg over 10 min. Group B: The tranexamic acid was given after induction intravenously as 15 mg/kg over 10 min and continued infusion as 5 mg/kg/h during surgery. Group C (control group): The patients did not receive tranexamic acid. The bleeding was assessed by the extent of blood loss using the Boezaart blood grading scale, measuring blood in the suction jar, and by visual estimation of 4 · 4 gauze pads. Results: The comparison of Boezaart blood grading scale and amount of blood loss was insignificant between the three groups (p > 0.05). Conclusion: The present study showed no effect of tranexamic acid in decreasing the tonsillectomyrelated bleeding and there is no complication related to tranexamic acid. We are recommending other studies to measure the fibrinolytic activity during tonsillectomy and its inhibition by tranexamic acid.

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Section: Discussionmentioning

confidence: 99%

Assessment of the effect of tranexamic acid on perioperative bleeding in pediatric patients undergoing tonsillectomy

Soliman

Alshehri²

2015

Egyptian Journal of Anaesthesia

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“…Antifibrinolytic drugs are widely used to reduce blood loss in a variety of hemorrhagic conditions, including severe trauma (1), cardiac and non-cardiac surgery (2)(3)(4)(5), and maternal hemorrhage (6). Safe and effective pharmacological blood conservation strategies are needed, as the risks and costs associated with allogenic blood transfusions continue to increase (7,8).…”

Section: Introductionmentioning

confidence: 99%

“…Glycine receptors are predominantly expressed in the spinal cord and brain stem but are also widely expressed in the prefrontal cortex, the hippocampus, and the amygdala (32). These receptors are pentameric chloride ion channels that are composed of α [1][2][3][4] and β subunits (33). The subunit composition of each receptor determines its pharmacological properties, as well as its expression patterns in the CNS and the subcellular regions of neurons (34).…”

Section: Introductionmentioning

confidence: 99%

Tranexamic acid concentrations associated with human seizures inhibit glycine receptors

Lecker¹,

Wang²,

Romaschin³

et al. 2012

J. Clin. Invest.

160

156

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Antifibrinolytic drugs are widely used to reduce blood loss during surgery. One serious adverse effect of these drugs is convulsive seizures; however, the mechanisms underlying such seizures remain poorly understood. The antifibrinolytic drugs tranexamic acid (TXA) and ε-aminocaproic acid (EACA) are structurally similar to the inhibitory neurotransmitter glycine. Since reduced function of glycine receptors causes seizures, we hypothesized that TXA and EACA inhibit the activity of glycine receptors. Here we demonstrate that TXA and EACA are competitive antagonists of glycine receptors in mice. We also showed that the general anesthetic isoflurane, and to a lesser extent propofol, reverses TXA inhibition of glycine receptor-mediated current, suggesting that these drugs could potentially be used to treat TXA-induced seizures. Finally, we measured the concentration of TXA in the cerebrospinal fluid (CSF) of patients undergoing major cardiovascular surgery. Surprisingly, peak TXA concentration in the CSF occurred after termination of drug infusion and in one patient coincided with the onset of seizures. Collectively, these results show that concentrations of TXA equivalent to those measured in the CSF of patients inhibited glycine receptors. Furthermore, isoflurane or propofol may prevent or reverse TXA-induced seizures.

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“…Patients who were given tranexamic acid prior to their TURP had 50% less blood loss than patients on placebo in one study. 16 Though this pharmacological agent may have a role in prostate cancer bleeding, there are concerns about its prothrombogenic potential in patients with advanced cancer who often have symptomatic cardiovascular and peripheral vascular disease.…”

Section: Discussionmentioning

confidence: 99%

Brachytherapy for advanced prostate cancer bleeding

Thurairaja

Pocock

Crundwell

et al. 2008

Prostate Cancer Prostatic Dis

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Advanced prostate cancer patients frequently deal with intractable prostatic bleeding which is a difficult problem to manage. Intraurethral high-dose rate (HDR) brachytherapy may palliate this condition. Advanced prostate cancer patients with intractable prostatic bleeding were offered brachytherapy with Iridium-192 using a Micro-selectron HDR machine. During a 5-year period, analysis was performed in 23 patients with a median age and Gleason score of 78 years and 9, respectively. Following brachytherapy, haematuria resolved in 19 of the 23 patients and was recurrence free at 6 months. Intraurethral HDR brachytherapy is a potentially effective modality for treating haematuria in patients with advanced prostate cancer.

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Tranexamic acid in control of primary hemorrhage during transurethral prostatectomy

Cited by 88 publications

References 30 publications

Assessment of the effect of tranexamic acid on perioperative bleeding in pediatric patients undergoing tonsillectomy

Assessment of the effect of tranexamic acid on perioperative bleeding in pediatric patients undergoing tonsillectomy

Tranexamic acid concentrations associated with human seizures inhibit glycine receptors

Brachytherapy for advanced prostate cancer bleeding

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