Comparison of two methods of bolus and infusion of Tranexamic acid to reduce blood loss in Total Knee Arthroplasty

Background: Until today, many studies conduct to determine the optimaldose and regimen of tranexamic acid to reduce the preoperative andpostoperative blood loss in primary total knee arthroplasty. In this study, wewere compared two different methods of administration (bolus and infusion).Materials and Methods: Forty patients were randomized in two groups; allthe patients received 500 mg tranexamic acid before tourniquet was turned on.Group (A) consisted of 20 patients (mean age: 64± 6.1 years) received 500mg tranexamic acid ten minutes before tourniquet was loosened and group(B) (63.5 ± 7.7 years) received 500 mg tranexamic acid IV infusion during 6hours from the time of tourniquet loosening (total dose of TA 1 g in bothgroups). Intraoperative blood loss, postoperative drainage (in 6 and 12 hours),blood transfusion (in 48 hours), hematocrit and hemoglobin decrease (6 and12 hours later) were compared between two groups.Results: The patients in group (B) had less blood loss intra- andpostoperative in 6 and 12 hours, and also had less hemoglobin decrease andpacked cell transfusion rate was significantly lower in these patients;compared to group (A).Conclusion: Our study demonstrated that infusion administration oftranexamic acid in primary total knee arthroplasty was more effective toreduce perioperative blood loss and the demand for blood transfusion in 48hours.

کلیدواژه ها:

tranexamic acid ، total knee arthroplasty ، blood transfusion