title: Effect of low dose tranexamic acid on intra-operative blood loss in neurosurgical patients.
abstract: BACKGROUND
  Blood loss is often a major complication in neurosurgery that requires transfusion of multiple units of blood. The purpose of this study was to assess the effect of tranexamic acid (TXA) on intraoperative blood loss and the need for blood transfusion in patients undergoing craniotomy for tumor excision.
  
  
  METHODS
  A total of 100 patients aged 18-60 years, with American Society of Anesthesiologists physical Status 1 and 2 scheduled to undergo elective craniotomy for tumor excision were enrolled. Patients received 10 mg/kg bolus about 20 min before skin incision followed by 1 mg/kg/h infusion of either TXA or saline. Hemodynamic variables, intravenous fluid transfused, amount of blood loss and blood given were measured every 2 h. Laboratory parameters such as serum electrolytes and fibrinogen values were measured every 3 h. On the 5(th) postoperative day hemoglobin (POD Hb5), Hb estimation was done and the estimated blood loss (EBL) calculated. Patients were also monitored for any complications.
  
  
  RESULTS
  The Mean heart rate in TXA group was significantly lower compared with the saline group. Mean arterial pressure and fibrinogen levels were higher in TXA group. The mean total blood loss in the TXA group was less than in the saline group. Blood transfusion requirements were comparable in two groups. The EBL and POD5 Hb were comparable in two groups.
  
  
  CONCLUSIONS
  Even though, there is a significant reduction in the total amount of blood loss in TXA group. However, there was no reduction in intraoperative transfusion requirement.
authors.affiliation: Department of Anesthesiology and Critical Care, JIPMER, Puducherry, India.
authors.forename: Ramya
authors.initials: R
authors.lastname: Vel
authors.affiliation: Department of Anesthesiology and Critical Care, JIPMER, Puducherry, India.
authors.forename: Bidkar Prasanna
authors.initials: BP
authors.lastname: Udupi
authors.affiliation: Department of Anesthesiology and Critical Care, JIPMER, Puducherry, India.
authors.forename: Munaganuri Venkata Siva
authors.initials: MV
authors.lastname: Satya Prakash
authors.affiliation: Department of Anesthesiology and Critical Care, JIPMER, Puducherry, India.
authors.forename: Sethuramachandran
authors.initials: S
authors.lastname: Adinarayanan
authors.affiliation: Department of Anesthesiology and Critical Care, JIPMER, Puducherry, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Mishra
authors.affiliation: Department of Anesthesiology and Critical Care, JIPMER, Puducherry, India.
authors.forename: Lenin
authors.initials: L
authors.lastname: Babu
keywords: Intraoperative blood loss; neurosurgery; tranexamic acid