The Effect of Single High-Dose Preoperative Intravenous Tranexamic Acid Administration to Reduce Blood Loss in Patients with Primary Total Knee Replacement

Abstract

Objectives: This study aimed to analyze the efficacy of single-dose tranexamic acid (TA) 20 mg/kg preoperatively to reduce blood loss in patients undergoing total knee replacement (TKR).

Methods: A total of 387 patients (82 males, 305 females) undergoing TKR between January 2014 and December 2018 were included in the study. The T + group was administrated intravenous (iv) TA 20 mg/kg 20 min before the skin incision. We determined perioperative blood loss, the amount of drainage postoperative 24 h, the amount of drainage after postoperative 24-48 h, total volume of drains, total volume of blood loss, postoperative hemoglobin and hematocrit levels, and amount of total blood transfusion.

Results: In terms of demographic data, no statistically significant difference was observed between the groups. Perioperative blood loss and total volume of blood loss was found statistically higher in T - group compared to T + group. Postoperatively, the mean hemoglobin and hematocrit levels of T - group were statistically significantly lower than T + group.

Conclusion: A single 20 mg/kg iv TA administration before TKR reduces bleeding during surgery and within 24 h postoperatively.

Keywords: Blood loss; deep vein thrombosis; knee replacement; tranexamic acid.

Figure 1

Perioperative and postoperative 48 hours blood loss(ml): Perioperative blood loss and drainage blood loss 0-24 hours were statistically higher than TXA + group in TXA - group. But there was no statistically significant difference between the two groups in the results of drainage blood loss between 24-28 hours.

Figure 2

Total allogeneic blood transfusion units: Allogeneic blood transfusion level in the TXA - group was significantly higher than in the TXA + group.