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Comparison of Two Methods of Bolus and Infusion of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty

Mohammadreza Moshari, Bahman Malek, Mohammadreza Minator-Sajjadi, Maryam Vosoghian, Mastaneh Dahi, Mahshid Ghasemi, Razieh Shekari
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Abstract

Abstract

BackgroundSo far, many studies have been performed to determine the optimal dose and regimen of tranexamic acid to reduce preoperative and postoperative blood loss in primary total knee arthroplasty. In the present study, two different methods of administration (bolus and infusion), were compared.

Materials and MethodsForty patients were randomized in the two groups (A and B) of 20 patients each. All patients received 500 mg tranexamic acid before inflation of tourniquet. Group A (mean age64± 6.1 years) received 500 mg tranexamic acid 10 minutes before loosening of tourniquet and group B (mean age, 63.5 ± 7.7 years) received 500 mg tranexamic acid through IV infusion during 6 hours from the time of tourniquet loosening (total dose of TA, 1 g in both groups). Intraoperative blood loss,postoperative drainage (in 6 and 12 hours), blood transfusion (in 48 hours), and decrease in hematocrit and hemoglobin (6 and 12 hours later), were compared between the two groups.

ResultsThe patients in group B had lower intra- and postoperative blood loss in 6 and 12 hours and also had lower decrease in hemoglobin, and their packed cell transfusion rate was significantly lower compared to the group A.

ConclusionThe findings of this study indicated that infusion administration of tranexamic acid in primary total knee arthroplasty, was more effective in the reduction of perioperative blood loss as well as need for blood transfusion in 48 hours.


Keywords

Tranexamic Acid, Total Knee Arthroplasty,Postoperative Blood Loss

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DOI: https://doi.org/10.22037/jcma.v3i1.18430

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