title: The effect of an intravenous bolus of tranexamic acid on blood loss in total hip replacement.
abstract: Tranexamic acid is a fibrinolytic inhibitor which reduces blood loss in total knee replacement. We examined the effect on blood loss of a standardised intravenous bolus dose of 1 g of tranexamic acid, given at the induction of anaesthesia in patients undergoing total hip replacement and tested the potential prothrombotic effect by undertaking routine venography. In all, 36 patients received 1 g of tranexamic acid, and 37 no tranexamic acid. Blood loss was measured directly per-operatively and indirectly post-operatively. Tranexamic acid reduced the early post-operative blood loss and total blood loss (p = 0.03 and p = 0.008, respectively) but not the intraoperative blood loss. The tranexamic acid group required fewer transfusions (p = 0.03) and had no increased incidence of deep-vein thrombosis. The reduction in early post-operative blood loss was more marked in women (p = 0.05), in whom this effect was dose-related (r = -0.793). Our study showed that the administration of a standardised pre-operative bolus of 1 g of tranexamic acid was cost-effective in reducing the blood loss and transfusion requirements after total hip replacement, especially in women.
authors.affiliation: The Elective Orthopaedic Centre, Epsom, Surrey, UK. krajesparan@hotmail.com
authors.forename: K
authors.initials: K
authors.lastname: Rajesparan
authors.forename: L C
authors.initials: LC
authors.lastname: Biant
authors.forename: M
authors.initials: M
authors.lastname: Ahmad
authors.forename: R E
authors.initials: RE
authors.lastname: Field
mesh_terms: D000368:Aged; D000933:Antifibrinolytic Agents / Q000191:economics / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000191:economics / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data; D015992:Body Mass Index; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D011300:Preoperative Care; D012737:Sex Factors; D014148:Tranexamic Acid / Q000191:economics / Q000627:therapeutic use*; D020246:Venous Thrombosis / Q000517:prevention & control*
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid