title: [Use of tranexamic acid in primary total knee replacement: effects on perioperative blood loss].
abstract: OBJECTIVE
  The use of tranexamic acid in primary total knee replacement surgeries has been the subject of constant study. The strategies to reduce bleeding are aimed at reducing the need for blood transfusion due to the risks involved. In this study we evaluated the use of tranexamic acid in reducing bleeding, need for blood transfusion, and prevalence of postoperative deep vein thrombosis (DVT) in primary total knee replacement.
  
  
  METHODS
  62 patients undergoing primary total knee replacement were enrolled in the study, from June 2012 to May 2013, and randomized to receive a single dose of 2.5g of intravenous tranexamic acid (Group TA) or saline (Group GP), 5minutes before opening the pneumatic tourniquet, respectively. Hemoglobin, hematocrit, and blood loss were recorded 24hours after surgery. DVT was investigated during patient's hospitalization and 15 and 30 days after surgery in review visits.
  
  
  RESULTS
  There was no demographic difference between groups. Group TA had 13.89% decreased hematocrit (p=0.925) compared to placebo. Group TA had a decrease of 12.28% (p=0.898) in hemoglobin compared to Group GP. Group TA had a mean decrease of 187.35mL in blood loss (25.32%) compared to group GP (p=0.027). The number of blood transfusions was higher in Group GP (p=0.078). Thromboembolic events were not seen in this study.
  
  
  CONCLUSIONS
  Tranexamic acid reduced postoperative bleeding without promoting thromboembolic events.
authors.affiliation: Unidade de Ensino Médico Propedêutica Anestésico Cirúrgica da Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil; Sociedade Brasileira de Anestesiologia (SBA), Rio de Janeiro, RJ, Brasil; Clínica de Anestesiologia de Caxias do Sul (CAN), Caxias do Sul, RS, Brasil. Electronic address: danielvolquind@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Volquind
authors.affiliation: Hospital Pompeia de Caxias do Sul, Caxias do Sul, RS, Brasil.
authors.forename: Remi Antônio
authors.initials: RA
authors.lastname: Zardo
authors.affiliation: Hospital Pompeia de Caxias do Sul, Caxias do Sul, RS, Brasil.
authors.forename: Bruno Costamilan
authors.initials: BC
authors.lastname: Winkler
authors.affiliation: Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil.
authors.forename: Bruno Bertagnolli
authors.initials: BB
authors.lastname: Londero
authors.affiliation: Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil.
authors.forename: Natália
authors.initials: N
authors.lastname: Zanelatto
authors.affiliation: Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil.
authors.forename: Gisele Perondi
authors.initials: GP
authors.lastname: Leichtweis
keywords: Anestesia; Anesthesia; Bleeding; Blood transfusion; Knee prosthesis; Prótese do joelho; Sangramento; Tranexamic acid; Transfusão de sangue; Ácido tranexâmico