Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Dec;53(6):667-71.

Efficacy and Safety of Tranexamic Acid in Control of Bleeding Following TKR: A Randomized Clinical Trial

P N Kakar  1 , Nishkarsh Gupta, Pradeep Govil, Vikram Shah
Affiliations

Efficacy and Safety of Tranexamic Acid in Control of Bleeding Following TKR: A Randomized Clinical Trial

P N Kakar et al. Indian J Anaesth. 2009 Dec.

Abstract

Total knee arthroplasty (TKA) is generally carried out using a tourniquet and blood loss occurring mainly post operatively is collected in drains. Tranexamic acid is an antifibrinolytic agent which decreases the total blood loss. Patients had unilateral / bilateral cemented TKA using combined spinal and epidural anaesthesia. In a double-blind fashion, they received either placebo (n=25) or tranexamic acid (n=25)10 mg.kg(-1) i.v., just before tourniquet inflation, followed by 1 mg kg(-1) h-1 i.v. till closure of the wound. The postoperative blood loss, transfusion requirement, cost effectiveness and complications were noted. The groups had similar characteristics. The mean volume of drainage fluid was 270 ml and 620 ml for unilateral(U/L) and bilateral(B/L) TKR patients in placebo group. Whereas it was 160ml and 286 ml respectively in unilateral(U/L) and bilateral(B/L) TKR patients who received tranexamic acid. This was considered statistically significant. Control group patients received 26 units of PRBC as compared to 4 units in tranexamic acid groups (p<0.001). This was again statistically significant. None of the patients in any of the groups developed deep vein thrombosis. Tranexamic acid decreased total blood loss by nearly 54% in B/L TKR and 40% in U/L TKR and drastically reduced (> 80%) blood transfusion.

Keywords: TKR; Tranexamic acid; blood loss.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Effect of TAX on Postoperative Blood loss
Fig 2
Fig 2
Effect of TAX on Postoperative blood transfusions
Fig 3
Fig 3
Effect of TAX on postoperative Hb concentration
See this image and copyright information in PMC

References

    1. Pier Mannuccio Mannuccio, Marcel Levi. Prevention and treatment of major blood loss. N Engl J Med. 2007;356:2301–11. - PubMed
    1. Sculco TP, Adams GL, et al. Global blood management in orthopedic surgery. Clin Orthop Relat Res. 1998;357:43–49. - PubMed
    1. Lisa Hall Zimmerman. Causes and consequences of critical bleeding and mechanism of blood coagulation. Pharmacotherapy. 2007;27:45S–56S. - PubMed
    1. Benoni G, Fredin H. Fibrinolytic inhibition with tranexamic acid reduces blood loss and blood transfusion after knee arthroplasty. A prospective, randomised, double-blind study of 86 patients. J Bone Joint Surg [Br] 1996;78-B:434–440. - PubMed
    1. Montserrat Vera-Llonch. Clinical and economic consequences of bleeding following major orthopedic surgery. Thrombosis Research. 2006;117:569–577. - PubMed