Intraarticular TXA Administration with Appropriate Timing of Clamping and Appropriate Dose is More Effective Than IV Administration
Jazyk angličtina Země Česko Médium print
Typ dokumentu časopisecké články, srovnávací studie
PubMed
38963893
DOI
10.55095/achot2024/019
Knihovny.cz E-zdroje
- MeSH
- antifibrinolytika * aplikace a dávkování MeSH
- injekce intraartikulární MeSH
- intravenózní podání MeSH
- konstrikce MeSH
- krevní transfuze statistika a číselné údaje MeSH
- krvácení při operaci * prevence a kontrola MeSH
- kyselina tranexamová * aplikace a dávkování MeSH
- lidé středního věku MeSH
- lidé MeSH
- pooperační krvácení prevence a kontrola etiologie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- totální endoprotéza kolene * metody škodlivé účinky MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- antifibrinolytika * MeSH
- kyselina tranexamová * MeSH
PURPOSE OF THE STUDY: Our aim was to compare the effects of intraarticular and intravenous (IV) tranexemic acid (TXA) application on bleeding and complication rates in patients who underwent total knee arthroplasty (TKA). MATERIAL AND METHODS: Between 2017 and 2021, 406 patients who underwent TKA with 2 g of IV TXA and retrograde 1.5 g of TXA applied through the drain were included in the study. Of the patients, 206 were in the IV TXA group. Preoperative and postoperative hemoglobin levels, drain output, BMI, ASA score, blood loss, and the number of transfused patients were recorded. Complications such as symptomatic venous thromboembolism were also recorded. RESULTS: There was no significant difference between the two groups in terms of age, sex, American Society of Anesthesiologists (ASA) score, or BMI (p = 0.68, 0.54, 0.28, 0.45). Total drain output and blood loss were significantly higher in the IV TXA group than in the intraarticular TXA group (p < 0.0001, p < 0.0001). Eighteen patients in the IV TXA group and 1 patient in the intraarticular TXA group received a blood transfusion (p < 0.0001). There was no difference between the two groups in terms of preoperative hemoglobin or platelet count (p = 0.24). However, postoperative hemoglobin level was higher in the patients who received intraarticular TXA (p=0.0005). More thromboembolism events were seen in the IV TXA group (p < 0.0001). CONCLUSIONS: Intraarticular TXA application reduces blood loss more than IV application, reduces the blood transfusion rate, and causes fewer complications. KEY WORDS: tranexemic acid, total knee arthroplasty, intraarticular injection, blood loss, blood transfusion.
Egepol Surgery Hospital Department of Orthopedics and Traumatology İzmir Turkey
VM Medicalpark Ankara Hospital Department of Orthopedics and Traumatology Ankara Turkey
Yıldırım Beyazıt University Department of Orthopedics and Traumatology Ankara Turkey
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