Result of tranexamic acid in controlling blood loss in total knee and hip replacement surgery

Abstract

Background: Blood loss is one of the major problems during intra-operative and postoperative periods after doing total knee and hip replacement. It is associated with high perioperative blood loss between 700 to 2,000 ml. High blood loss can lead to a longer hospital stay, impedes rehabilitation and may be poorly tolerated by patients with cardiovascular diseases (CVD). Aims and Objective: To evaluate the effect of intravenously administered tranexamic acid (TXA) in controlling blood loss in total knee and hip replacement surgery. Materials and Methods: Fifty patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA) were studied from April 2014 to March 2016 after dividing them into Group 1 (n=25; total hip replacement) and Group 2 (n=25; total knee replacement). All patients received TXA10 mg/kg 15 min before incision. As a primary outcome transfusion incidence, drain output, postoperative hemoglobin and hematocrit drop were evaluated. As a secondary outcome incidence of symptomatic deep vein thrombosis and pulmonary embolism within 30 days of surgery were evaluated. Results: Female preponderance was noted (60%). Pre operative hemoglobin was higher (11.72 gm%) as compared to post operative hemoglobin at 2nd (9.9 gm%) and 4th day (9.5 gm%) of surgery in Group 1 as well as in Group 2 pre operative hemoglobin was higher (11.78 gm%) as compared to post operative hemoglobin at 2nd (9.6 gm%) and 4th day (9.3 gm%). Drain (ml) output in Group 1 and Group 2 was 150.2 and 170.4 ml respectively. Blood transfusion was required only in one patient in Group 2. Conclusion: TXA administered through intra venous route was found to decrease postoperative bleeding and requirement of transfusion in unilateral TKA and THR without increasing any risk of complications