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Randomized Controlled Trial
. 2020 Jul-Aug;70(4):318-324.
doi: 10.1016/j.bjan.2020.03.015. Epub 2020 Jul 8.

[Comparison of two doses of intra-articular tranexamic acid on postoperative bleeding in total knee arthroplasty: a randomized clinical trial]

[Article in Portuguese]
Edmundo Pereira de Souza Neto  1 , Gorka Usandizaga  2
Affiliations
Randomized Controlled Trial

[Comparison of two doses of intra-articular tranexamic acid on postoperative bleeding in total knee arthroplasty: a randomized clinical trial]

[Article in Portuguese]
Edmundo Pereira de Souza Neto et al. Braz J Anesthesiol. 2020 Jul-Aug.

Abstract

Introduction: Tranexamic Acid (TXA), an antifibrinolytic that inhibits the fibrinolytic activity of plasmin is used to decrease perioperative blood loss and transfusion requirements in orthopedic surgery. The aim of our study was to compare postoperative bleeding in two intra-articular doses (1 g and 2 g) of tranexamic acid in adult patients undergoing unilateral total knee replacement.

Method: We conducted a single-operator, randomized, and controlled, double-blind study in two groups. The G1 group received 1 g of intra-articular TXA and the G2 group 2 g of intra-articular TXA. Both groups received 15 mg kg−1 IV before the surgical incision (TXA induction dose) and then 10 mg kg−1, orally, 6 and 12 hours after the induction dose of TXA.

The primary endpoint was bleeding measured by blood loss in postoperative drainage. Secondary outcomes were change in hemoglobin and hematocrit levels on the first and third postoperative days, and the need for transfusion during hospitalization.

Results: In total, 100 patients were randomized, and 100 were included in the analysis. Blood loss in postoperative drainage was similar in both groups (200 ± 50 vs. 250 ± 50 mL, G1 and G2 groups respectively). Change in hematocrit and hemoglobin values (% of change) between preoperative and day 3 were not statically significant between groups G1 and G2 (18 ± 5 vs. 21 ± 4; 21 ± 7 vs. 22 ± 5 respectively). No patients received blood transfusion.

Conclusions: Our study did not show superiority of 2 g of intra-articular tranexamic acid compared to 1 g.

ClinicalTrials.gov Identifier NCT04085575

Keywords: Artroplastia total do joelho; Hemorragia; Hemorrhage; Hemostasia; Hemostasis; Intravenosa; Intravenous; Intra‐articular; Topical; Total knee arthroplasty; Tranexamic acid; Tópico; Ácido tranexâmico.

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Figures

Fig. 1
Figure 1
Comparison of two doses of intra-articular tranexamic acid on postoperative bleeding in total knee arthroplasty: a randomized clinical trial, Consort flow diagram.
See this image and copyright information in PMC

References

    1. Habermann E.T. Total joint replacement: an overview. Semin Roentgenol. 1986;21:7–19. - PubMed
    1. Prasad N., Padmanabhan V., Mullaji A. Blood loss in total knee arthroplasty: an analysis of risk factors. Int Orthop. 2007;31:39–44. - PMC - PubMed
    1. Ortmann E., Besser M.W., Klein A.A. Antifibrinolytic agents in current anaesthetic practice. Br J Anaesth. 2013;111:549–563. - PubMed
    1. Tan J., Chen H., Liu Q., et al. A meta-analysis of the effectiveness and safety of using tranexamic acid in primary unilateral total knee arthroplasty. J Surg Res. 2013;184:880–887. - PubMed
    1. Jang B., Kao M., Bohm M.T., et al. Intra-articular injection of tranexamic acid to reduce blood loss after total knee arthroplasty. J Orthop Surg (Hong Kong) 2014;22:146–149. - PubMed

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