Combination of tranexamic acid and dexmedetomidine reduces postoperative blood loss in patients undergoing bilateral total knee replacement - A randomized controlled study

2018 ◽  
Vol 7 (1) ◽  
pp. 32-35
Author(s):  
Koramutla Pradeep Kumar ◽  
◽  
J Subhashree ◽  
Chittaranjan Sahu ◽  
G Jagadesh ◽  
...  
Keyword(s):  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Randomized Controlled Study ◽  
Postoperative Blood Loss ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Total Knee ◽  
Bilateral Total Knee Replacement

scholarly journals A non-randomized prospective study of the blood sparing effect of tranexamic acid in total knee replacement

2016 ◽  
Vol 3 (1) ◽  
pp. 12
Author(s):  
Anand Gupta ◽  
Ashok Nagla ◽  
Vinay Tantuway ◽  
Rishi Gupta ◽  
Vivek Patel ◽  
...  
Keyword(s):  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Subcutaneous Tissue ◽  
Skin Incision ◽  
Total Blood Loss ◽  
Postoperative Blood Loss ◽  
Total Blood ◽  
Total Knee

<p class="abstract"><strong>Background:</strong> Several techniques are available to minimize the likelihood of blood transfusion following total knee arthroplasty. Tranexamic acid, an inhibitor of fibrinolysis that blocks the lysine-binding site of plasminogen to fibrin has been reported to reduce intraoperative and postoperative blood loss in patients undergoing total hip and total knee arthroplasties with or without cement. The objective of this study was to assess the efficacy of antifibrinolytic treatment along with other measures like saline adrenaline infusion, no drain, no tourniquet and hypotensive anaesthesia in reducing perioperative blood loss during total knee replacement<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Between January 2011 to January 2016,  seventy five consecutive patients who had given written informed consent, undergoing a TKR received tranexamic acid 15 mg/kg body weight intravenous 5 minutes before the skin incision and two doses afterwards (3 and 6 hours after the first dose respectively). TKR was performed in a routine fashion without tourniquet. The saline adrenaline (1:200000) was infiltrated into the skin subcutaneous tissue and capsule before skin incision. A routine closure was carried out without drain. Total blood loss including the hidden blood loss was calculated. All patients were monitored for anemia and postoperative thromboembolic complications.<strong></strong></p><p class="abstract"><strong>Results:</strong> The average total blood loss in study group is 433 ± 148 ml. This is much lesser than what other studies have reported. Mean reduction in hemoglobin levels (gm/dl) between preoperative and postoperative readings is 1.6 gm/dl. One patient had a postoperative DVT which was treated with rivaroxaban 20 mg OD for 6 weeks (oral anticoagulant)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Antifibrinolytic agents like tranexamic acid used along with other measures reported in this study produces a significant decrease in blood loss in patients undergoing total knee replacement<span lang="EN-IN">.</span></p>

scholarly journals Predicting Factors for Allogeneic Blood Transfusion and Excessive Postoperative Blood Loss after Single Low-Dosage Intra-Articular Tranexamic Acid Application in Total Knee Replacement

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Paphon Sa-ngasoongsong ◽  
Siwadol Wongsak ◽  
Noratep Kulachote ◽  
Pongsthorn Chanplakorn ◽  
Patarawan Woratanarat ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Postoperative Blood Loss ◽  
Total Blood ◽  
Predicting Factors ◽  
Total Knee ◽  
Low Bmi

Background.Recently, intra-articular tranexamic acid (IA-TXA) application has become a popular method for perioperative blood loss (PBL) reduction in total knee replacement (TKR). Nevertheless, through our knowledge, no previous studies had shown the correlation perioperative factors and the risk of excessive PBL or need of blood transfusion (BT) after IA-TXA.Materials and Methods.A retrospective study was conducted in patients underwent 299 primary TKRs, using IA-TXA, during 2-year period (2013-2014). Patient’s characteristic and perioperative data were reviewed and collected. PBL was measured as total hemoglobin loss (THL), estimated total blood loss (ETBL), and drainage volume per kg (DV/kg). Excessive PBL was defined as PBL that exceeded 90th percentile.Results. From multivariate analysis, low preoperative hemoglobin (Hb) level and body mass index (BMI) were the significant predictors of postoperative BT (p<0.0001and 0.003, resp.). Excessive THL significant associated with preoperative Hb (p<0.0001). Excessive ETBL significantly associated with preoperative Hb, height, preoperative range-of-motion, and creatinine clearance (p<0.05all). Low BMI and large prosthesis size were the significant predictors of excessive DV/kg (p=0.0001and 0.002, resp.).Conclusions. Low preoperative Hb and BMI were the significant risks of postoperative transfusion after TKR with IA-TXA. Moreover, multiple perioperative factors could result in higher PBL.

scholarly journals An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Paphon Sa-ngasoongsong ◽  
Pongsthorn Chanplakorn ◽  
Siwadol Wongsak ◽  
Krisorn Uthadorn ◽  
Tanapong Panpikoon ◽  
...  
Keyword(s):  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Low Dose ◽  
Postoperative Blood Loss ◽  
Systemic Absorption ◽  
Drainage Fluid ◽  
Significant Difference ◽  
Total Knee

Background. Recently, combined intra-articular tranexamic acid (IA-TXA) injection with clamping drain method showed efficacy for blood loss and transfusion reduction in total knee replacement (TKR). However, until now, none of previous studies revealed the effect of this technique on pharmacokinetics, coagulation, and fibrinolysis.Materials and Methods. An experimental study was conducted, during 2011-2012, in 30 patients undergoing unilateral TKR. Patients received IA-TXA application and then were allocated into six groups regarding clamping drain duration (2-, 4-, 6-, 8-, 10-, and 12-hours). Blood and drainage fluid were collected to measure tranexamic acid (TXA) level and related coagulation and fibrinolytic markers. Postoperative complication was followed for one year.Results. There was no significant difference of serum TXA level at 2 hour and 24 hour among groups(p<0.05). Serum TXA level at time of clamp release was significantly different among groups with the highest level at 2 hour(p<0.0001). There was no significant difference of TXA level in drainage fluid, postoperative blood loss, blood transfusion, and postoperative complications(p<0.05).  Conclusions. Low-dose IA-TXA application in TKR with prolonged clamping drain method is a safe and effective blood conservative technique with only minimal systemic absorption and without significant increase in systemic absorption over time.

Topical (Intra-Articular) Tranexamic Acid Reduces Blood Loss and Transfusion Rates Following Total Knee Replacement

2013 ◽  
Vol 95 (21) ◽  
pp. 1961-1968 ◽  
Author(s):  
Sattar Alshryda ◽  
James Mason ◽  
Manesh Vaghela ◽  
Praveen Sarda ◽  
Antoni Nargol ◽  
...  
Keyword(s):  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Total Knee
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