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Effect of tranexamic acid on reducing postoperative blood loss in combined hypotensive epidural anesthesia and general anesthesia for total hip replacement

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Author(s)
Yong-Cheol LeeSang-Jin ParkJi-Seob KimChul-Hyun Cho
Keimyung Author(s)
Lee, Yong CheolCho, Chul Hyun
Department
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Dept. of Orthopedic Surgery (정형외과학)
Journal Title
Journal of Clinical Anesthesia
Issued Date
2013
Volume
25
Issue
5
Keyword
Blood loss: surgicalHypotensive epidural anesthesiaTotal hip replacementTranexamic acid
Abstract
Study Objective:

To determine whether the use of tranexamic acid in the setting of hypotension induced by hypotensive epidural anesthesia (HEA) has any additional beneficial effects in reducing perioperative blood loss and transfusion requirements in total hip replacement.


Design:

Prospective, randomized, double-blinded trial.


Setting:

University-affiliated hospital.


Patients:

68 adult, ASA physical status 1 and 2 patients undergoing primary unilateral cementless total hip replacement with general anesthesia and HEA.


Interventions:

The HEATA group received a bolus dose of 15 mg/kg of tranexamic acid before surgical incision, followed by a continuous 15 mg/kg infusion until skin closure. The HEA group received normal saline instead of tranexamic acid in the same manner.


Measurements:

Intraoperative blood loss was measured using the difference between the weights of used gauze and the original unused gauze, in addition to the blood volume accumulated in suction bottles. Postoperative blood loss was considered to be the amount of blood accumulated in drainage bags.


Main Results:

There was no significant difference in intraoperative blood loss between the HEA and HEATA groups (251.8 ± 109.9 mL vs 234.9 ± 93.9 mL), but postoperative blood loss was significantly less in the HEATA group than the HEA group (439.3 ± 171. 6 mL vs 1074.4 ± 287.1 mL), as was total cumulative blood loss (674.2 ± 216.4 mL vs 1326.2 ± 347.8 mL). There was no significant difference in intraoperative transfusion incidences, but postoperative transfusion was greater in the HEA group than the HEATA group.


Conclusions:

Administration of tranexamic acid combined with hypotensive epidural anesthesia reduced postoperative and total accumulative blood loss and transfusion requirements more than did hypotensive epidural anesthesia alone.
Keimyung Author(s)(Kor)
이용철
조철현
Publisher
School of Medicine
Citation
Yong-Cheol Lee et al. (2013). Effect of tranexamic acid on reducing postoperative blood loss in combined hypotensive epidural anesthesia and general anesthesia for total hip replacement. Journal of Clinical Anesthesia, 25(5), 393–398. doi: 10.1016/j.jclinane.2013.02.006
Type
Article
ISSN
0952-8180
Source
https://www.sciencedirect.com/science/article/pii/S0952818013001785?via%3Dihub
DOI
10.1016/j.jclinane.2013.02.006
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33975
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
1. School of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학)
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