Tranexamic acid reduces postoperative blood loss of degenerative lumbar instability with stenosis in posterior approach lumbar surgery: a randomized controlled trial

Wang, Qi; Liu, Jun; Fan, Rong; Chen, Yu; Yu, Hailong; Bi, Yan; Hua, Zhengzhe; Piao, Meihui; Guo, Mingming; Ren, Weijian; Xiang, Liangbi

doi:10.1007/s00586-013-2836-z

Cited by 83 publications

(64 citation statements)

References 24 publications

(30 reference statements)

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“…However, clinically there was reduction in requirement of blood transfusion in Group II (TXA group), the discrepancy being most likely due to the small sample size. These results were consistent with studies done by Wong et al 7 Elwatidy et al 8 and Wang et al 9 Wong et al 7 reported that total estimated and calculated perioperative blood loss was approximately 25% and 30% lower in patients given TXA versus placebo (P <0.017), respectively, in adult patients undergoing spinal fusion surgery.…”

Section: Discussionsupporting

confidence: 91%

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A randomized prospective study of efficacy of Tranexamic Acid on Perioperative Blood Loss in Thoracic Spine Fixation

Basavaraj¹,

Hegde²

2017

Sri Lankan J Anaesthesiol

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Background: Spine surgery is associated with significant blood loss, often requiring blood transfusion. The objective of this double blind study was to evaluate the efficacy of tranexamic acid (TXA) on perioperative blood loss in patients undergoing thoracic spine fixation. Materials and Methods:Sixty adult patients were randomized into two groups of 30 each. Group I received a bolus of 15 mg/kg i.v. of TXA after induction followed by a maintenance infusion of 1 mg/kg/hr up to closure of skin and Group II received an equivalent volume of normal saline after induction followed by a maintenance infusion of saline up to closure of skin. Outcome measures included perioperative blood loss, amount of blood transfusion, postoperative haemoglobin and haematocrit levels. Results:The mean perioperative blood loss was less in the TXA group compared to the placebo group (p value<0.001). The PRBCs transfusion was lower in the TXA group compared to the placebo group but there was no statistically significant difference between the two groups. The postoperative haemoglobin level was lower in the control group as compared to TXA group (p value <0.05). Conclusion:TXA is effective in reducing peri-operative blood loss and blood transfusion.

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Section: Discussionsupporting

confidence: 91%

“…Wang et al 9 reported that postoperative blood loss was significantly lower in the TXA group than in the control group (13.0%) in posterior-approach lumbar surgery for degenerative lumbar instability with stenosis.…”

Section: Discussionmentioning

confidence: 98%

A randomized prospective study of efficacy of Tranexamic Acid on Perioperative Blood Loss in Thoracic Spine Fixation

Basavaraj¹,

Hegde²

2017

Sri Lankan J Anaesthesiol

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“…These inconsistent results may warrant more number of future refined studies, despite most high level of evidence studies favor the use of TXA in spinal surgery5,24,25). Most studies showed tendency toward less postoperative bleeding in TXA group with or without statistical significance1,20,24,25). Present study also demonstrated less postoperative drain amount in TXA group without reaching statistical significance.…”

Section: Discussionmentioning

confidence: 58%

“…Baldus and colleagues concluded in their study in patients undergoing lumbar pedicle subtraction osteotomy that TXA use did not decrease surgical bleeding or intraoperative transfusion amount whereas using aprotinin did1). These inconsistent results may warrant more number of future refined studies, despite most high level of evidence studies favor the use of TXA in spinal surgery5,24,25). Most studies showed tendency toward less postoperative bleeding in TXA group with or without statistical significance1,20,24,25).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Tranexamic Acid in Spinal Deformity Surgery

Choi

Hyun

Kim

et al. 2017

J Korean Neurosurg Soc

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ObjectiveSpinal deformity surgery has the potential risk of massive blood loss. To reduce surgical bleeding, the use of tranexamic acid (TXA) became popular in spinal surgery, recently. The purpose of this study was to determine the effectiveness of intra-operative TXA use to reduce surgical bleeding and transfusion requirements in spinal deformity surgery.MethodsA total of 132 consecutive patients undergoing multi-level posterior spinal segmental instrumented fusion (≥5 levels) were analyzed retrospectively. Primary outcome measures included intraoperative estimated blood loss (EBL), transfusion amount and rate of transfusion. Secondary outcome measures included postoperative transfusion amount, rate of transfusion, and complications associated with TXA or allogeneic blood transfusions.ResultsThe number of patients was 89 in TXA group and 43 in non-TXA group. There were no significant differences in demographic or surgical traits between the groups except hypertension. The EBL was significantly lower in TXA group than non-TXA group (841 vs. 1336 mL, p=0.002). TXA group also showed less intra-operative and postoperative transfusion requirements (544 vs. 812 mL, p=0.012; 193 vs. 359 mL, p=0.034). Based on multiple regression analysis, TXA use could reduce surgical bleeding by 371 mL (37 % of mean EBL). Complication rate was not different between the groups.ConclusionTXA use can effectively reduce the amount of intra-operative bleeding and transfusion requirements in spinal deformity surgery. Future randomized controlled study could confirm the routine use of TXA in major spinal surgery.

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“…The half-life of TXA has been reported to be 2 hours, and its effective plasma concentration is 1 mg/mL. With an intravenous injection of 15 mg/kg, it will remain at levels greater than the effective plasma concentration for 16 hours postoperatively and is, thus, the most effective at this time (24).…”

Section: Discussionmentioning

confidence: 95%

Administration of Tranexamic Acid Reduces Postoperative Blood Loss in Calcaneal Fractures: A Randomized Controlled Trial

Xie

Tian

Zhou

2015

The Journal of Foot and Ankle Surgery

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Tranexamic acid reduces postoperative blood loss of degenerative lumbar instability with stenosis in posterior approach lumbar surgery: a randomized controlled trial

Abstract: Preoperative single-dose TXA can significantly reduce postoperative blood loss in posterior approach lumbar surgery, and there were no significant side effects.

Cited by 83 publications

References 24 publications

A randomized prospective study of efficacy of Tranexamic Acid on Perioperative Blood Loss in Thoracic Spine Fixation

A randomized prospective study of efficacy of Tranexamic Acid on Perioperative Blood Loss in Thoracic Spine Fixation

Effectiveness and Safety of Tranexamic Acid in Spinal Deformity Surgery

Administration of Tranexamic Acid Reduces Postoperative Blood Loss in Calcaneal Fractures: A Randomized Controlled Trial

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