Publication:

Effects of tranexamic acid in major orthopedic surgical procedures: a randomized comparative study

Background Despite modern healthcare system, major surgeries always cause economical constraints. Complications due to blood loss, long hospital stay are most common in major surgical procedures. Tranexamic acid (TXA), a synthetic derivative of lysine is used instead of blood transfusion to control bleeding peri and post operatively. Hence this study was planned to assess the effects of tranexamic acid on various orthopedic surgical procedures, in terms of blood loss, duration of surgical procedure and hospital stay.

Methods Prospective randomized comparative study, among patients undergoing elective and emergency orthopedic surgery. Patients with multiple fractures, organ injury and CKD were excluded from this study. Patients were randomized to tranexamic acid (TXA) group and colloids, blood transfusion group based on computer generated random numbers. Thirty two patients were randomized to tranexamic acid group and thirty two in control group. Statistical analysis was done using SPSS V 20.

Results The mean age group was 38.41±11.4 and 36.83±13.5 in TXA group and control group respectively. The mean SD for blood loss in TXA group was 321.5±124.7 and control group 482.7±189.6, the difference was found to be highly statistically significant with p=0.0002. Likewise the difference in postoperative Hb was found to be statistically significant with p<0.01. The p value for surgical site infection and hematoma was not statistically significant.

Conclusions TXA significantly reduces blood loss and blood transfusion requirements in patients undergoing orthopedic surgery.