Comparison of bleeding and transfusions in primary hip and knee arthroplasties with single doses of tranexamic acid vs. placebo in a University Hospital. A prospective study
DOI:
https://doi.org/10.1016/j.rccot.2016.10.004Keywords:
tranexamic acid, hip arthroplasty, knee arthroplastyAbstract
Background: Tranexamic acid is an antifibrinolitic which has been used for many years in orthopedic surgery, in orderto decrease bleeding during and after surgery. However, an administration protocol has not been established. The aim of our study was to determine if a monodosis of 20 mg/kg iv of tranexamic acid is effective in reducing peri-operative bleeding.
Materials and methods: This is a prospective, randomized, double blind study. 62 patients had been evaluated from June 2014 to December 2015. We measured preoperative and postoperative hematocrit and hemoglobin, days of stay in hospital and number of red cell unit transfusion. We looked for complications and adverse effects.
Results: We discovered that tranexamic acid group had less decrease in hematocrit and hemoglobin levels than control group. Tranexamic acid group had a mean drop of 7,9 hematocrit points and 2,7 g/dl hemoglobin level, whereas control group had a mean drop of 10,5 hematocrit points and 3,7 g/dl hemoglobin level. 20% of control group received blood cell transfusion, while only 1 of 32 cases in tranexamic acid group received blood cell transfusion. Stay in hospital was longer in control group.
Discussion: We concluded that a monodosis of 20 mg/kg iv of tranexamic acid is an effective protocol to reduce bleeding, transfusions, and stay in hospital in patients going under primary hip and knee arthroplasty. This is a prospective, randomized, double blind clinical trial.
Evidence level: I.
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