Med Bull Sisli Etfal Hosp. 2019; 53(2): 137-142 | DOI: 10.14744/SEMB.2018.73604

The Effect of Single High-Dose Preoperative Intravenous Tranexamic Acid Administration to Reduce Blood Loss in Patients with Primary Total Knee Replacement

Mehmet Ali Talmaç¹, Mehmet Akif Görgel¹, Sema Ertan Birsel², Mehmet Mesut Sönmez¹, Hacý Mustafa Özdemir^1
1Department of Orthopaedics, Health Sciences University Sisli Etfal Training and Research Hospital, Istanbul, Turkey
²Department of Orthopaedics, Istanbul Private Medicine Hospital, Istanbul, Turkey

Objectives: This study aimed to analyze the efficacy of single-dose tranexamic acid (TA) 20 mg/kg preoperatively to reduce blood loss in patients undergoing total knee replacement (TKR).
Methods: A total of 387 patients (82 males, 305 females) undergoing TKR between January 2014 and December 2018 were included in the study. The T + group was administrated intravenous (iv) TA 20 mg/kg 20 min before the skin incision. We determined perioperative blood loss, the amount of drainage postoperative 24 h, the amount of drainage after postoperative 24–48 h, total volume of drains, total volume of blood loss, postoperative hemoglobin and hematocrit levels, and amount of total blood transfusion.
Results: In terms of demographic data, no statistically significant difference was observed between the groups. Perioperative blood loss and total volume of blood loss was found statistically higher in T − group compared to T + group. Postoperatively, the mean hemoglobin and hematocrit levels of T − group were statistically significantly lower than T + group.
Conclusion: A single 20 mg/kg iv TA administration before TKR reduces bleeding during surgery and within 24 h postoperatively.

Keywords: Blood loss, deep vein thrombosis; knee replacement; tranexamic acid.

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The Effect of Single High-Dose Preoperative Intravenous Tranexamic Acid Administration to Reduce Blood Loss in Patients with Primary Total Knee Replacement

Mehmet Ali Talmaç¹, Mehmet Akif Görgel¹, Sema Ertan Birsel², Mehmet Mesut Sönmez¹, Hacý Mustafa Özdemir^1
1Saðlýk Bilimleri Üniversitesi Þiþli Hamidiye Etfal Eðitim Araþtýrma Hastanesi Ortopedi Klinði, Ýstanbul
²Ýstanbul Özel Medicine Hospital, Ýstanbul

Amaç: Bu çalýþmanýn amacý total diz replasmaný (TDR) yapýlan hastalarda ameliyat öncesi intravenöz tek doz 20 mg/kg traneksamik asit (TA) uygulamasýnýn etkinliðini analiz etmektir.
Yöntem: Ocak 2014 ile Aralýk 2018 arasýnda TDR uygulanan toplam 387 hasta (82 erkek, 305 kadýn) çalýþmaya alýndý. T + grubu, cilt insizyonundan önce intravenöz (iv) TA 20 mg / kg uygulanan hastalardan oluþuyordu. Ameliyat sonrasý kan kaybýný, postoperatif 24 saat sonra drenaj miktarýný, postoperatif 24-48 saat arasý drenaj miktarýný, drenlerden gelen toplam hacmi, total kan kaybýný, postoperatif hemoglobin ve hematokrit seviyelerini ve total kan transfüzyon miktarýný belirledik.
Bulgular: Gruplar arasýnda demografik veriler açýsýndan istatistiksel olarak anlamlý bir fark yoktu. Perioperatif kan kaybý ve total kan kaybý, T - grubunda, T + grubuna göre istatistiksel olarak daha yüksek bulundu. Postoperatif dönemde, T - grubunun ortalama hemoglobin ve hematokrit düzeyleri, T + grubundan istatistiksel olarak anlamlý derecede düþüktü.
Çýkarýmlar: TDR'den önce tek bir doz 20 mg/kg iv TA uygulamasý ameliyat sýrasýnda ve postoperatif 24 saat içinde kanamayý azaltýr.

Anahtar Kelimeler: Kan kaybý, diz replasmaný, traneksamik asit, derin ven trombozu

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