Effect of tranexamic acid in perioperative blood loss associated with total knee replacement: Our experience

• Main Authors: Kumar AHA, Bandari G, Reddy IV
• Format: Article
• Language: English
• Published: KIMS Foundation and Research Center 2016-01-01
• Series: Journal of Medical and Scientific Research
• Subjects: Tranexamic acid; perioperative blood loss; knee replacement
• Online Access: http://jmsronline.com/article.aspx?ID=Effect-of-tranexamic-acid-in-perioperative-blood-loss-associated-with-total-knee-replacement
• ISSN: 2321-1326; 2394-112X

Introduction: Costs of allogeneic blood transfusions and the associated risks mandate strategies to reduce blood loss in surgery. The objective of this study was to assess the efficacy of anti-fibrinolytic treatment in reducing perioperative blood loss during total knee replacement. Materials and methods: A retrospective and prospective study was carried out on 148 patients undergoing total knee replacement. 88 patients received tranexamic acid (10 mg/kg, iv) just before the cementation, 3 hours post operatively and 6 hours later. 60 patients did not receive tranexamic acid. Perioperative blood loss was measured the amount of post-operative drain, and drop in hemoglobin levels. The number of patients who needed blood transfusion and number of packed red cell (PRC) units transfused was recorded and possible postoperative thromboembolic complications were studied clinically. Results: Amongst 88 patients who were given tranexamic acid, only 35 (39.7%) were given blood transfusions and the average transfusion was 0.5 units. Amongst 60 patients who were not given tranexamic acid, 45 (75%) were given blood transfusions and the average transfusions were 1.3 units. The average blood loss in the group of patients who were given tranexamic acid was 164.97ml while in the group which were not given, the average blood loss was 305.48ml. The average drop in Hemoglobin in tranexamic acid given group was 1.5 grams%, and in tranexamic acid not given group was 1.8 grams%. Clinical assessment did not reveal any thromboembolic complications. Conclusions: Antifibrinolytic agents produce a significant decrease in blood loss in patients undergoing total knee replacement, reflected in the reduction in the number of blood transfusions required.