title: The prophylactic role of tranexamic acid to reduce blood loss during radical surgery: A prospective study.
abstract: BACKGROUND
  The radical surgical procedures are associated with perioperative blood loss. This study was aimed to evaluate the clinical efficacy and safety of tranexamic acid in reducing perioperative blood loss in patients undergoing radical surgery.
  
  
  METHODS
  Sixty ASA class I and II adult consented female patients, scheduled for elective radical surgery and met the inclusion criterion, were blindly randomized into two groups to receive either intravenous 1 g tranexamic acid 20 min before skin incision or an equivalent volume of normal saline as placebo (P). All patient's total blood loss was measured and recorded perioperatively at the 12(th)h postoperatively. The preoperative and postoperative hemoglobin, hematocrit values, serum creatinine, activated thromboplastin time, prothombin time, thrombocyte count, fibrinogen, D-dimer, and symptoms of pulmonary embolism were comparatively evaluated.
  
  
  RESULTS
  The tranexamic acid significantly reduced the quantity of total blood loss, 576 ± 53 mL in study group as compared to 823 ± 74 mL in the control group (P<0.01). Postoperatively hematocrit values were higher in the tranexamic acid group. The coagulation profile did not differ between the groups, but D-dimer concentrations were increased in the control group. No complications or adverse effects were reported in the either group.
  
  
  CONCLUSIONS
  The prophylactic administration of tranexamic acid has effectively reduced theblood loss and transfusion needs during radical surgery without any adverse effects or complication of thrombosis.
authors.affiliation: Department of Anaesthesiology and Critical Care, N.S.C.B. Subharti Medical College, Subhartipuram, Meerut, Uttar Pradesh, India.
authors.forename: Kumkum
authors.initials: K
authors.lastname: Gupta
authors.affiliation: Department of Anaesthesiology and Critical Care, N.S.C.B. Subharti Medical College, Subhartipuram, Meerut, Uttar Pradesh, India.
authors.forename: Bhawna
authors.initials: B
authors.lastname: Rastogi
authors.affiliation: Department of Surgery, N.S.C.B. Subharti Medical College, Subhartipuram, Meerut, Uttar Pradesh, India.
authors.forename: Atul
authors.initials: A
authors.lastname: Krishan
authors.affiliation: Department of Anaesthesiology and Critical Care, N.S.C.B. Subharti Medical College, Subhartipuram, Meerut, Uttar Pradesh, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Anaesthesiology and Critical Care, N.S.C.B. Subharti Medical College, Subhartipuram, Meerut, Uttar Pradesh, India.
authors.forename: V P
authors.initials: VP
authors.lastname: Singh
authors.affiliation: Department of Anaesthesiology and Critical Care, N.S.C.B. Subharti Medical College, Subhartipuram, Meerut, Uttar Pradesh, India.
authors.forename: Salony
authors.initials: S
authors.lastname: Agarwal
keywords: Antifibrinolytic agent; coagulation profile; hematocrit values; tranexamic acid