Neurobionplus
Home About Journal AHEAD OF PRINT Current Issue Back Issues Instructions Submission Search Subscribe Blog    
Login 

Users Online: 1506 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
ORIGINAL ARTICLE

Effectiveness and safety of the combined use of tranexamic acid: A comparative observational study of 1909 cases


1 Department of Anesthesiology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
2 Department of Biostatistics, Hospices Civils de Lyon, Lyon; University of Lyon I F-69100; Laboratory of Biometry and Biology, CNRS, UMR 5558, F-69100, Villeurbanne, Lyon, France
3 Department of Surgery, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France

Correspondence Address:
Charles-Herve Vacheron,
Département D'anesthésie Réanimation, Hospices Civils De Lyon, Centre Hospitalier Lyon Sud, 165 Chemin Du Grand Revoyet, 69310 Pierre Bénite
France
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ortho.IJOrtho_148_19

Background: Tranexamic acid (TA) use in lower-limb arthroplasty has been valued in these surgeries high-risk hemorrhagic due to its antifibrinolytic action. The objective of the present study was to determine the effectiveness of the combined intravenous (IV) and intraarticular (IA) administration of TA in lower-limb arthroplasty. Methods: We conduct a prospective observational study between January 1, 2014, and December 31, 2017, including all programmed lower-limb arthroplasties. Patients were divided into four groups: no TA, 15 mg/kg IV TA, 3 g IA TA, and 15 mg/kg IV and 3 g IA. The effect on calculated total blood loss (milliliter of red blood cell [RBC]), hemoglobin, transfusion, and duration of hospitalization was studied after adjustment on age, American Society of Anesthesiologists, surgery, and postoperative curative anticoagulation. Complications related to TA administration were systematically reported. Results: A total of 1909 patients were included – “no TA,” n = 184; “IV,” n = 1137; “IA,” n = 214; and “IV + IA,” n = 374. In the IV + IA group, a decrease in blood loss was observed compared to the no TA group (+220 ml 95% confidence interval [CI] [184; 255] of RBC P < 0.001) and in the IA group (+65 ml 95% CI [30; 99] of RBC P < 0.001). The length of hospital stay of the IV + IA group was shorter compared to the no TA group (hazard ratio [HR] 0.35, 95% CI [0.29; 0.43], P < 0.001) to the IA group (HR 0.57, 95% CI [0.48; 0.69], P < 0.001) and the IV group (HR 0.45, 95% CI [0.39; 0.50], P < 0.001). One case of deep vein thrombosis occurred in the group without TA. Conclusion: Administration of combined TA appears effective and safe; further studies are needed in order to establish a consensual protocol.

  Search Pubmed for
 
    -  Vacheron CH
    -  Roy P
    -  Petit PY
    -  Appery J
    -  Fessy M
    -  Piriou V
    -  Viste A
    -  Friggeri A
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed42    
    PDF Downloaded2    

Recommend this journal