Comparison of Two Methods of Bolus and Infusion of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty

authors:

avatar Mohammadreza Moshari ORCID 1 , * , avatar Bahman Malek 1 , avatar Mohammadreza Minator Sajjadi 1 , avatar Maryam Vosoughian ORCID 2 , avatar Mastaneh Dahi Taleghani ORCID 3 , avatar Mahshid Ghasemi ORCID 1 , avatar Razieh Shekari 4

MD, Assistant Professor, Anesthesiology Research Center,Shahid Beheshti University of Medical Sciences, Tehran, Iran
MD, Associate Professor, Anesthesiology Research Center,Shahid Beheshti University of Medical Sciences, Tehran, Iran
MD, Associate Professor,Anesthesiology Research Center,Shahid Beheshti University of Medical Sciences, Tehran, Iran
MD, Anesthesiology Research Center,Shahid Beheshti University of Medical Sciences, Tehran, Iran
Journal of Cellular & Molecular Anesthesia: Vol.3, issue 1; e149556
article type: Original Articles
DOI: https://doi.org/10.22037/jcma.v3i1.18430

how to cite: Moshari M, Malek B, Minator Sajjadi M, Vosoughian M, Dahi Taleghani M, et al. Comparison of Two Methods of Bolus and Infusion of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty. J Cell Mol Anesth. 2018;3(1):e149556. https://doi.org/10.22037/jcma.v3i1.18430.

Abstract

AbstractBackground:?So far, many studies?have been performed?to determine the optimal dose and regimen of?tranexamic acid to reduce?preoperative and postoperative blood loss in primary total knee?arthroplasty. In the present?study, two different methods of administration (bolus and infusion),?were?compared.Materials and Methods:?Forty patients were randomized in?the two groups?(A and B)?of 20 patients each. All patients received 500 mg?tranexamic acid before?inflation of?tourniquet. Group A (mean age,?64? 6.1 years) received 500 mg tranexamic acid?10?minutes before?loosening of?tourniquet and?group B (mean age,?63.5 ? 7.7 years) received 500 mg?tranexamic acid?through?IV infusion during 6 hours from the?time of tourniquet loosening (total dose of TA,?1 g in both groups). Intraoperative blood loss,postoperative drainage (in 6 and 12 hours), blood transfusion (in 48 hours),?and decrease in?hematocrit?and?hemoglobin?(6 and 12 hours later),?were compared between?the?two groups.Results:?The patients in group B had?lower?intra- and postoperative?blood loss?in 6 and 12?hours and also had?lower decrease in?hemoglobin,?and?their?packed cell transfusion rate was significantly?lower compared to?the?group A.Conclusion:?The findings of this?study?indicated?that infusion administration of tranexamic acid in?primary total knee arthroplasty,?was more effective?in the reduction of?perioperative blood loss?as well as?need?for blood transfusion in 48 hours.