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

Ashwin Kumar AH, Gopinath Bandari, Reddy IV

Pdf Page Numbers :- 1-3

 Ashwin Kumar AH¹, Gopinath Bandari^1,*, and Reddy IV¹

¹Department of Orthopaedics, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India

*Corresponding author: Dr. Gopinath Bandari, Department of Orthopaedics, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India. Email: gopinath.bandari@gmail.com

Received 23 October 2015; Revised 11 December 2015; Accepted 22 December 2015; Published 29 December 2015

Citation: Kumar AHA, Bandari G, Reddy IV. Effect of tranexamic acid in perioperative blood loss associated with total knee replacement: Our experience. J Med Sci Res. 2016; 4(1):1-3. DOI: http://dx.doi.org/10.17727/JMSR.2016/4-001

Copyright: © 2016 Kumar AHA, et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

 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.

Keywords: Tranexamic acid; perioperative blood loss; knee replacement