The Effectiveness of 1 g Intravenous Tranexamic Acid in Reducing Blood Loss in Total Hip and Knee Replacement Surgeries: A Double-blind Controlled Study in a Regional Hospital
Background: Tranexamic acid (TXA) is one of the pharmacological drugs employed to reduce haemorrhage during total hip replacement (THR) and total knee replacement (TKR), but there is yet to be consensus on the doses and timing of administration during surgery. AIM: This is to assess the effectivenes...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-09-01
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| Series: | Nigerian Journal of Medicine |
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| Online Access: | https://journals.lww.com/10.4103/NJM.NJM_140_23 |
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| author | Michael Ebiyon Ugbeye Kehinde Adesola Alatishe Sulaimon Olatunji Olanrewaju Wakeel Olaide Lawal Ine Prattson Adadevoh Imeh James Akpan Uche C. Nwose |
| author_facet | Michael Ebiyon Ugbeye Kehinde Adesola Alatishe Sulaimon Olatunji Olanrewaju Wakeel Olaide Lawal Ine Prattson Adadevoh Imeh James Akpan Uche C. Nwose |
| author_sort | Michael Ebiyon Ugbeye |
| collection | DOAJ |
| description | Background:
Tranexamic acid (TXA) is one of the pharmacological drugs employed to reduce haemorrhage during total hip replacement (THR) and total knee replacement (TKR), but there is yet to be consensus on the doses and timing of administration during surgery.
AIM:
This is to assess the effectiveness of 1 g intravenous (IV) TXA compared to placebo for reducing blood loss in THR and TKR.
Patients, Materials and Methods:
This was a prospective randomised double-blind study conducted in our regional hospital between January 2016 and June 2017. THR and TKR patients were randomly allocated to placebo and TXA groups. Intraoperative blood loss (IBL), postoperative blood loss (PBL), total blood loss (TBL), haemoglobin (Hb) drop, duration of surgery, and transfusion rates were outcomes compared between the two groups.
Results:
The administration of 1000 mg (15 mg/kg) TXA significantly reduces IBL, PBL, and TBL by 30%, 31%, and 25.8%, respectively, when compared to placebo in patients who had THR. The mean IBL (187.7 ± 46.2 mL), PBL (334.4 ± 85.9 mL), and TBL (574.3 ± 102.1 mL) in the TXA group were significantly lower than those in the placebo group (344.3 ± 89.0 mL, 628.0 ± 197.4 mL, and 946.5 ± 152.3 mL) (P < 001), respectively, in TKR patients. There was a significant reduction in Hb drop in the TXA group when compared to the placebo group in both THR and TKR patients. The number of THR and TKR patients who received blood transfusions was significantly lower in the TXA group. Mean surgical time in the TXA group was reduced by 0.3 h during THR. However, there was no significant difference in the surgical time between TXA and placebo groups in TKR (P = 0.970).
Conclusion:
One gram of IV TXA is effective in reducing perioperative bleeding, Hb loss, and the need for blood transfusion requirements in THR and TKR. |
| format | Article |
| id | doaj-art-4351dcf1202a4c34a3f1530a8ea3d0d3 |
| institution | OA Journals |
| issn | 1115-2613 2667-0526 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Nigerian Journal of Medicine |
| spelling | doaj-art-4351dcf1202a4c34a3f1530a8ea3d0d32025-08-20T02:16:09ZengWolters Kluwer Medknow PublicationsNigerian Journal of Medicine1115-26132667-05262024-09-0132663363810.4103/NJM.NJM_140_23The Effectiveness of 1 g Intravenous Tranexamic Acid in Reducing Blood Loss in Total Hip and Knee Replacement Surgeries: A Double-blind Controlled Study in a Regional HospitalMichael Ebiyon UgbeyeKehinde Adesola AlatisheSulaimon Olatunji OlanrewajuWakeel Olaide LawalIne Prattson AdadevohImeh James AkpanUche C. NwoseBackground: Tranexamic acid (TXA) is one of the pharmacological drugs employed to reduce haemorrhage during total hip replacement (THR) and total knee replacement (TKR), but there is yet to be consensus on the doses and timing of administration during surgery. AIM: This is to assess the effectiveness of 1 g intravenous (IV) TXA compared to placebo for reducing blood loss in THR and TKR. Patients, Materials and Methods: This was a prospective randomised double-blind study conducted in our regional hospital between January 2016 and June 2017. THR and TKR patients were randomly allocated to placebo and TXA groups. Intraoperative blood loss (IBL), postoperative blood loss (PBL), total blood loss (TBL), haemoglobin (Hb) drop, duration of surgery, and transfusion rates were outcomes compared between the two groups. Results: The administration of 1000 mg (15 mg/kg) TXA significantly reduces IBL, PBL, and TBL by 30%, 31%, and 25.8%, respectively, when compared to placebo in patients who had THR. The mean IBL (187.7 ± 46.2 mL), PBL (334.4 ± 85.9 mL), and TBL (574.3 ± 102.1 mL) in the TXA group were significantly lower than those in the placebo group (344.3 ± 89.0 mL, 628.0 ± 197.4 mL, and 946.5 ± 152.3 mL) (P < 001), respectively, in TKR patients. There was a significant reduction in Hb drop in the TXA group when compared to the placebo group in both THR and TKR patients. The number of THR and TKR patients who received blood transfusions was significantly lower in the TXA group. Mean surgical time in the TXA group was reduced by 0.3 h during THR. However, there was no significant difference in the surgical time between TXA and placebo groups in TKR (P = 0.970). Conclusion: One gram of IV TXA is effective in reducing perioperative bleeding, Hb loss, and the need for blood transfusion requirements in THR and TKR.https://journals.lww.com/10.4103/NJM.NJM_140_23blood losseffectivenessintravenous tranexamic acidtotal hip replacementtotal knee replacement |
| spellingShingle | Michael Ebiyon Ugbeye Kehinde Adesola Alatishe Sulaimon Olatunji Olanrewaju Wakeel Olaide Lawal Ine Prattson Adadevoh Imeh James Akpan Uche C. Nwose The Effectiveness of 1 g Intravenous Tranexamic Acid in Reducing Blood Loss in Total Hip and Knee Replacement Surgeries: A Double-blind Controlled Study in a Regional Hospital Nigerian Journal of Medicine blood loss effectiveness intravenous tranexamic acid total hip replacement total knee replacement |
| title | The Effectiveness of 1 g Intravenous Tranexamic Acid in Reducing Blood Loss in Total Hip and Knee Replacement Surgeries: A Double-blind Controlled Study in a Regional Hospital |
| title_full | The Effectiveness of 1 g Intravenous Tranexamic Acid in Reducing Blood Loss in Total Hip and Knee Replacement Surgeries: A Double-blind Controlled Study in a Regional Hospital |
| title_fullStr | The Effectiveness of 1 g Intravenous Tranexamic Acid in Reducing Blood Loss in Total Hip and Knee Replacement Surgeries: A Double-blind Controlled Study in a Regional Hospital |
| title_full_unstemmed | The Effectiveness of 1 g Intravenous Tranexamic Acid in Reducing Blood Loss in Total Hip and Knee Replacement Surgeries: A Double-blind Controlled Study in a Regional Hospital |
| title_short | The Effectiveness of 1 g Intravenous Tranexamic Acid in Reducing Blood Loss in Total Hip and Knee Replacement Surgeries: A Double-blind Controlled Study in a Regional Hospital |
| title_sort | effectiveness of 1 g intravenous tranexamic acid in reducing blood loss in total hip and knee replacement surgeries a double blind controlled study in a regional hospital |
| topic | blood loss effectiveness intravenous tranexamic acid total hip replacement total knee replacement |
| url | https://journals.lww.com/10.4103/NJM.NJM_140_23 |
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