scholarly journals Effect of intravenous aminocaproic acid on blood loss and transfusion requirements after bilateral varus rotational osteotomy (VRO): a prospective, double-blinded, randomized controlled trial

2018 ◽  
Vol 60 ◽  
pp. 6-6
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Loss ◽  
Controlled Trial ◽  
Aminocaproic Acid ◽  
Rotational Osteotomy ◽  
Randomized Controlled ◽  
Transfusion Requirements ◽  
Double Blinded

scholarly journals Randomized Controlled Trial of Laparoscopic versus Open Radical Cystectomy in a Laparoscopic Naïve Center

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Waleed Mohamed Fadlalla ◽  
Ayman Hanafy ◽  
Mahmoud Abdelhakim ◽  
Hatem Aboulkassem ◽  
El Sayed Ashraf ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Loss ◽  
Hospital Stay ◽  
Radical Cystectomy ◽  
Controlled Trial ◽  
Complication Rates ◽  
Randomized Controlled ◽  
Transfusion Requirements ◽  
Laparoscopic Cystectomy ◽  
Open Radical Cystectomy

Background. Laparoscopic radical cystectomy is a challenging surgical procedure; however, it has been largely abandoned in favor of the more intuitive robotic-assisted cystectomy. Due to the prohibitive cost of robotic surgery, the adoption of laparoscopic cystectomy is of relevance in low-resource institutes. Methodology. This is a randomized controlled trial comparing laparoscopic radical cystectomy (LRC) to open radical cystectomy (ORC) at a single institute. Each group included thirty patients. The trial was designed to compare both approaches regarding operative time, blood loss, transfusion requirements, length of hospital stay, time to oral intake, requirement of opioid analgesia, and complications. Results. LRC was associated with less hospital stay (9.8 vs. 13.8 days, P = 0.001 ), less time to oral solid intake (6 vs. 8.6 days, P = 0.031 ), and lower opioid requirements (23.3% vs. 53.3%, P = 0.033 ). There was a trend towards lower blood loss and transfusion requirements, but this did not reach statistical significance. Overall complication rates were comparable. Conclusion. Laparoscopic radical cystectomy was associated with comparable postoperative outcomes when compared to ORC in the first laparoscopic cystectomy experience in our center. Benefitting from the assistance of an experienced laparoscopic surgeon is recommended to shorten the learning curve.

Tranexamic acid or epsilon-aminocaproic acid in total joint arthroplasty? A randomized controlled trial

2019 ◽  
Vol 101-B (9) ◽  
pp. 1093-1099 ◽  
Author(s):  
Kendall E. Bradley ◽  
Sean P. Ryan ◽  
Colin T. Penrose ◽  
Stuart A. Grant ◽  
Samuel S. Wellman ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Prospective Studies ◽  
Controlled Trial ◽  
Aminocaproic Acid ◽  
Randomized Controlled ◽  
Epsilon Aminocaproic Acid

Aims Antifibrinolytic agents, including tranexamic acid (TXA) and epsilon-aminocaproic acid (EACA), have been shown to be safe and effective for decreasing perioperative blood loss and transfusion following total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, there are few prospective studies that directly compare these agents. The purpose of this study was to compare the benefits of intraoperative intravenous TXA with EACA. Patients and Methods A total of 235 patients (90 THA and 145 TKA) were enrolled in this prospective, randomized controlled trial at a single tertiary-care referral centre. In the THA cohort, 53.3% of the patients were female with a median age of 59.8 years (interquartile range (IQR) 53.3 to 68.1). In the TKA cohort, 63.4% of the patients were female with a median age of 65.1 years (IQR 59.4 to 69.5). Patients received either TXA (n = 119) or EACA (n = 116) in two doses intraoperatively. The primary outcome measures included change in haemoglobin level and blood volume, postoperative drainage, and rate of transfusion. Secondary outcome measures included postoperative complications, cost, and length of stay (LOS). Results TKA patients who received EACA had greater drainage (median 320 ml (IQR 185 to 420) vs 158 ml (IQR 110 to 238); p < 0.001), increased loss of blood volume (891 ml (IQR 612 to 1203) vs 661 ml (IQR 514 to 980); p = 0.014), and increased haemoglobin change from the preoperative level (2.1 ml (IQR 1.7 to 2.8) vs 1.9 ml (IQR 1.2 to 2.4); p = 0.016) compared with patients who received TXA. For the THA cohort, no statistically significant differences were observed in any haematological outcome measure. One patient in the EACA group required transfusion. No patient in the TXA group required transfusion. There were no statistically significant differences in number or type of postoperative complications or LOS for either THA or TKA patients regardless of whether they received TXA or EACA. Conclusion For hip and knee arthroplasty procedures, EACA is associated with increased perioperative blood loss compared with TXA. However, there is no significant difference in transfusion rate. While further prospective studies are needed to compare the efficacy of each agent, we currently recommend orthopaedic surgeons to select their antifibrinolytic based on cost and regional availability. Cite this article: Bone Joint J 2019;101-B:1093–1099.

Pre-operative tranexemic acid vs. etamsylate in reducing blood loss during elective cesarean section: randomized controlled trial

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Haitham Torky ◽  
El-Sayed El-Desouky ◽  
Ibrahim Abo-Elmagd ◽  
Attia Mohamed ◽  
Ahmad Abdalhamid ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Side Effects ◽  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Controlled Trial ◽  
Elective Cesarean Section ◽  
Randomized Controlled ◽  
Elective Cesarean ◽  
Double Blinded

AbstractObjectivesTo investigate whether etamsylate may be an alternative to tranexamic acid in reduction of blood loss during elective cesarean section.MethodsProspective double-blinded multi-center randomized controlled trial involving 180 qualified women equally divided into three groups each containing 60 women received either tranexamic acid, etamsylate or placebo 20 min before elective cesarean section and blood loss was estimated.ResultsMean blood loss, cases needing blood transfusion and cases needing further interventions were significantly lower in tranexamic acid and etamsylate group than placebo group, while mean postoperative hemoglobin and hematocrite were significantly higher in both tranexamic acid and etamsylate as compared to placebo.ConclusionsEtamsylate is an effective second-line therapy (after tranexamic acid) in reducing blood loss during elective cesarean section with low risk of side effects, therefore, it can be an effective alternative to tranexamic acid in cases with contraindications or anticipated to be at high-risk of developing side effects from tranexamic acid.

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