title: Topical Application of Tranexamic Acid Plus Diluted Epinephrine Reduces Postoperative Hidden Blood Loss in Total Hip Arthroplasty.
abstract: We evaluated the efficacy and safety of topical application of tranexamic acid (TXA) plus diluted epinephrine (DEP) and its effect on perioperative hidden blood loss and transfusion requirement in primary unilateral total hip arthroplasty (THA). We randomized 107 patients undergoing THA into two groups: 53 received intra-articular TXA 3 g plus 1:200,000 DEP 0.25 mg; 54 received topical TXA 3 g alone. Results showed that combined administration significantly reduced total blood loss (P=0.009), hidden blood loss (P=0.001) and transfusion rate (1.9 vs. 9.3%) compared with TXA alone, without increasing the risks of thromboembolic and hemodynamic complications. Topical TXA plus DEP in THA can decrease postoperative hidden blood loss and avoid homologous transfusion without substantial complications.
authors.affiliation: Osteonecrosis and Joint-Preserving and Reconstruction Center, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China, Beijing, China.
authors.forename: Fuqiang
authors.initials: F
authors.lastname: Gao
authors.affiliation: Osteonecrosis and Joint-Preserving and Reconstruction Center, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.affiliation: Osteonecrosis and Joint-Preserving and Reconstruction Center, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China, Beijing, China.
authors.forename: Wanshou
authors.initials: W
authors.lastname: Guo
authors.affiliation: Osteonecrosis and Joint-Preserving and Reconstruction Center, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China, Beijing, China.
authors.forename: Zirong
authors.initials: Z
authors.lastname: Li
authors.affiliation: Osteonecrosis and Joint-Preserving and Reconstruction Center, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China, Beijing, China.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Wang
authors.affiliation: Osteonecrosis and Joint-Preserving and Reconstruction Center, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China, Beijing, China.
authors.forename: Liming
authors.initials: L
authors.lastname: Cheng
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011184:Postoperative Period; D014148:Tranexamic Acid / Q000008:administration & dosage*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D000933:Antifibrinolytic Agents; D014662:Vasoconstrictor Agents; D014148:Tranexamic Acid; D004837:Epinephrine
keywords: epinephrine; hidden blood loss; topical; total hip arthroplasty; tranexamic acid; transfusion