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Use of tranexamic acid reduced blood loss in hip arthroplasty
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MANCHESTER — Administering a bolus of 1g intravenous tranexamic acid prior to hip arthroplasty surgery can help curb intraoperative and postoperative blood loss and the need for transfusion, according to a report presented here.
Orthopedic surgeons at the Elective Orthopaedic Centre in Surrey, England, presented details of a cohort comparison study of 73 patients who underwent primary hip arthroplasty. Thirty-six patients received tranexamic acid (TA group) and 37 received no tranexamic acid and served as a control group.
The investigators measured blood loss directly intraoperatively and indirectly postoperatively using a hemoglobin and hematocrit measurement, according to their abstract. They measured deep vein thrombosis (DVT) using venography, lead investigator Kannan Rajesparan, MRCS, said at the British Orthopaedic Association Annual Congress 2009.
The amount of early postoperative blood loss and total blood loss were less in the tranexamic acid group, and fewer patients in that group required a transfusion, Rajesparan said. The amount of intraoperative blood loss did not change.
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The effect of tranexamic acid was more significant in women who demonstrated a dose-related relationship between tranexamic acid dose and blood loss.
Perhaps most importatly, “There was no increased incidence of DVT in the tranexamic acid group,” he said.
“We believe the use of a single preoperative 1g bolus of tranexamic acid administered before surgery is a safe and cost-effective way to reduce postoperative blood loss and transfusions in hip replacement surgery … and the effect is more significant in females at this dose,” he said.
He estimated that routine use of the antifibrinolytic in hip arthroplasty cases “could conceivably save 2.5 million [British] pounds a year” in reduced transfusions.
When asked about the timing of dosing, he said the current research suggests that the tranexamic acid seems to work best when administered approximately 15 minutes prior to arthroplasty surgery.
He also said women in the study lost more blood in the early postoperative period than the male patients, but he could not explain why.
Reference:
- Rajesparan K, Biant L, Ahmad M, Field R. Tranexamic acid in hip arthroplasty surgery. Presented at the British Orthopaedic Association Annual Congress 2009. Sept. 15-18, 2009. Manchester.