2025, Number 1
Efficacy of single-dose preoperative tranexamic acid to prevent blood loss in total hip and knee joint replacement
Language: Spanish
References: 11
Page: 8-12
PDF size: 309.22 Kb.
ABSTRACT
Introduction: transfusion-related complications are a major concern for surgeons performing total hip and knee arthroplasty (THA and TKA). Several strategies have been implemented to reduce transfusion rates, including the use of tranexamic acid (TXA), whose optimal dosage remains a matter of debate. Objective: to evaluate the efficacy and safety of a single pre-surgical dose of TXA in reducing blood loss in THA and TKA. Material and methods: sixty patients were enrolled. Patients were randomly assigned to either a control group (no TXA) or an experimental group (1 g TXA 30 minutes before surgery). Blood loss, blood transfusion rate and volume, and hemoglobin levels were analyzed. Results: hemoglobin loss in the control group was 3.5 ± 1.4 g/dl compared to 2.5 ± 1.5 g/dl in the experimental group (p = 0.006). Hematocrit loss was 10.6% ± 3.5 in the control group and 8% ± 4.9 in the experimental group (p = 0.02). Blood transfusion was only required in 3 patients (5%): 2 in the control group and 1 in the experimental group (p = 0.4). Conclusions: a single pre-surgical intravenous dose of 1 g TXA reduces hemoglobin loss in patients undergoing THA and TKA.REFERENCES
CRASH-2 trial collaborators; Shakur H, Roberts I, Bautista R, Caballero J, Coats T, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010; 376(9734): 23-32.
Balachandar G, Abuzakuk T. Is there an optimal timing of administration of single-dose intravenous tranexamic acid in bilateral total knee arthroplasty? A comparison between preoperative and intraoperative dose. J Orthop Surg (Hong Kong). 2019; 27(3): 2309499019880915. doi: 10.1177/2309499019880915.
Sanz-Reig J, Parra Ruiz B, Ferrández Martínez J, Martínez López JF. Dosis única intravenosa de ácido tranexámico como medida de ahorro transfusional en prótesis total primaria de rodilla [Single intravenous tranexamic acid dose to reduce blood loss in primary total knee replacement]. Rev Esp Cir Ortop Traumatol. 2016; 60(2): 106-12. Spanish. Available in: https://doi.org/10.1016/j.recote.2016.01.005
EVIDENCE LEVEL
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