Efficacy of single dose and additional dose of tranexamic acid for reduction of blood loss in total knee arthroplasty

• Published in: The Journal of arthroplasty 2017-07, Vol.32 (7), p.2108-2112
• Main Authors: Sun, Qi, M.D, Wu, JieZhou, M.D, Ge, Wei, M.D, Cai, Ming, Ph.D
• Format: Article
• Language: English
• Subjects: additional administration; Administration, Intravenous; Aged; Antifibrinolytic Agents - administration & dosage; Antifibrinolytic Agents - adverse effects; Arthroplasty, Replacement, Knee; blood loss; Blood Loss, Surgical - prevention & control; Blood Transfusion - statistics & numerical data; Female; Humans; intravenous administration; Male; Middle Aged; Orthopedics; Postoperative Hemorrhage - prevention & control; Postoperative Period; Prospective Studies; total knee arthroplasty; tranexamic acid; Tranexamic Acid - administration & dosage; Tranexamic Acid - adverse effects; Venous Thrombosis - chemically induced
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2016.10.003

Abstract Background The study aimed to evaluate the efficacy and safety of different regimen with single dose and additional postoperative dose of tranexamic acid in reducing of blood loss in total knee arthroplasty. Methods A total of 180 patients who scheduled to undergo primary unilateral total knee arthroplasty in our level I trauma center were recorded and divided into group A, B, C and D randomly. Preoperative dose, additional postoperative dose and twice postoperative additional dose of tranexamic acid were infused intravenously in group A (30mg/kg), B (15mg/kg) and C (10mg/kg) respectively, tranexamic acid was not infused in group D. Blood loss (intraoperative, postoperative and total blood loss), blood transfusion rate and volume, hemoglobin level, and incidence of deep vein thrombosis were analyzed. Results The total blood loss and postoperative blood loss were significantly lower in group B and C without difference between them. As for intraoperative blood loss, there was no significant difference between group A and B and between group B and C with superior efficacy than group D. Conclusion With same total dose of tranexamic acid, the preoperative dose and additional dose of tranexamic acid was superior to single preoperative dose of tranexamic acid in reducing blood loss in total knee arthroplasty. Besides, once additional dose was comparable to twice additional dose for tranexamic acid in reduction of blood loss.