Tranexamic acid given intraoperatively reduces blood loss after total knee replacement: a randomized, controlled study.
BACKGROUND
Extensive blood loss in total knee replacement (TKR) surgery is well known and is associated with a high transfusion rate of allogenic blood. Tranexamic acid (TXA) has been shown to reduce blood loss by 50% in this patient group, but only in cases with a perioperative loss of 1400-1800 ml. This study was performed to see if TXA offers any advantages in knee replacement surgery with blood loss at 800 ml.


METHODS
Thirty consecutive patients scheduled for TKR in spinal anesthesia with the use of a tourniquet, were randomized to TXA or non-TXA. Tranexamic acid 10 mg kg-1 was given at conclusion of surgery and again 3 h later. Blood loss was registered.


RESULTS
Total blood loss was at all times significantly lower in the TXA group compared to the non-TXA group (409.7+/-174.9 ml vs. 761.7+/-313.1 ml; P<0.001). There were no differences in coagulation parameters. No patients in the TXA group had a blood transfusion vs. 13% in the non-TXA group (NS). No complications were registered in the two groups.


CONCLUSIONS
We conclude that TXA significantly reduces blood loss after total knee replacement surgery.
Veien
M
M
Department of Anesthesiology, and Orthopedic Surgery, Aarhus Amtssygehus, Aarhus University Hospital, Denmark. mveien@dadlnet.dk
Sørensen
J V
JV
Madsen
F
F
Juelsgaard
P
P
D000368:Aged; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001810:Blood Volume / Q000187:drug effects; D005260:Female; D016558:Hemostasis, Endoscopic; D006801:Humans; D007430:Intraoperative Care / Q000706:statistics & numerical data*; D008297:Male; D013997:Time Factors; D014148:Tranexamic Acid / Q000627:therapeutic use*
D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid