Effects of high-dose tranexamic acid in total hip replacement: A prospective, double-blind, randomized controlled study
Keywords:Tranexamic acid, Total hip replacement, Blood transfusion
Aim: Different studies support the use of tranexamic acid (TA) to decrease the rate of transfusions in total hip replacement. This study aimed to investigate the effects of high-dose TA in total hip replacement.
Methods: Sixty American Society of Anesthesiologist (ASA) class I-III 60 adult patients were randomly assigned into 2 groups as group TA and group control (C) for this study. While, TA was administered at dose of 50 mg/kg to group TA, the group C received 100 cc normal saline (NS). In all subjects, blood samples were taken pre-surgery and 24 hours after the operation in order to study hemoglobin (Hgb), hematocrit (Hct), platelet count, prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen, D-dimer, blood urea nitrogen (BUN), creatinine, and cystatin-c. The amount of intraoperative bleeding and number of given packed of red blood cell (PRBCs) were recorded.
Results: The amount of blood loss and number of PRBCs given were significantly lower, and Hgb values at discharge were significantly higher in group TA compared with group C. In group TA postoperative cystatin-c levels, compared with the preoperative period, were significantly low. The length of hospital stay was significantly short in group TA.
Conclusion: TA was given intravenously before incision reduces intraoperative blood loss and the use of PRBCs in total hip replacement. This approach also provided higher Hgb values at discharge. The provision of TA shortened length of hospital stay and did not negatively affect renal function.
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