title: Effectiveness of oral Tranexamic acid administration on blood loss after knee artroplasty: a randomized clinical trial.
abstract: BACKGROUND
  Some studies have proved that Tranexamic acid infusion is associated with a decrease in blood loss during and after surgery. Due to the availability of an oral form of the drug, the rapid and complete absorption of it and ease of administration without need for specific instruments, we evaluated the effectiveness of the oral form in decreasing blood loss after total knee arthroplasty.
  
  
  METHODS
  In this double-blind, randomized, parallel clinical trial study, we evaluated 53 patients undergoing knee arthroplasty admitted to Ghaem hospital, Mashhad in 2012. Patients with any history of severe ischemic heart diseases, renal failure, cirrhosis, history of bleeding disorders or thromboembolic events, were excluded from the study. The patients were randomly allocated into 27 patients with and 26 patients without Tranexamic acid. Blood loss (mL) at 12 and at 24h and hematocrit at 24h were measured postoperatively. The results were analyzed with SPSS software (11.5 version) using independent and paired sample t-tests. A p-value ≤ 0.05 was considered to be significant.
  
  
  RESULTS
  The average blood loss after 12h of surgery in the control and Tranexamic acid groups were 462.9 (± 147.4) and 274.6 (± 139)mL, respectively (p<0.001) and after 24h of surgery they were 588.8 (± 193)and 364 (± 165.1)mL, respectively (p<0.001). The mean decrease in the hematocrit after surgery was 4.7% in the Tranexamic acid group and 6.8% in the control group (p=0.016).
  
  
  CONCLUSIONS
  Prescription of oral Tranexamic acid before knee arthroplasty can cause remarkable decrease in blood loss after surgery and also less decrease in hematocrit. The advantages of the oral route of the drug versus the intravenous form is that it can be used routinely as a safe and effective way to decrease bleeding after surgery.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Alipour
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Tabari
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Keramati
authors.forename: Azam Moradi
authors.initials: AM
authors.lastname: Zarmehri
authors.forename: Hadi
authors.initials: H
authors.lastname: Makhmalbaf
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014148:Tranexamic Acid / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: Bleeding; Knee arthroplasty; Oral Tranexamic acid