Intravenous drip and topical application using tranexamic acid decrease hidden blood loss after total hip arthroplasty

doi:10.3969/j.issn.2095-4344.2015.44.004

Abstract

Abstract:

BACKGROUND: Tranexamic acid has been more and more used in reducing bleeding after joint replacement, but its usage method and dosage remain controversial, and become a hot focus in recent years.

OBJECTIVE: To investigate the efficacy and safety of intravenous drip combined with intra-articular injection of tranexamic acid on postoperative hidden blood loss in patients who received primary total hip arthroplasty.

METHODS: Clinical data of 65 patients undergoing primary total hip arthroplasty were randomized to the test group and the control group. The patients in the test group received 0.5 g tranexamic acid through intravenous drip when the surgery starts and 0.5 g tranexamic acid inside hip joint through a drainage tube after capsule closure, and retaining for 6 hours. The patients in the control group intravenously received the same volume of physiological saline, and 50 mL physiological saline through a drainage tube after suture, and retaining for 6 hours. We compared with intraoperative blood loss, postoperative dominant blood loss and hidden blood loss, pain score, blood transfusion rate, deep vein thrombosis and day of hospitalization in both groups.

RESULTS AND CONCLUSION: Hemoglobin and hematocrit were higher in the test group than in the control group after replacement (P < 0.05). The volumes of dominant blood loss and hidden blood loss were lower in the test group than in the control group after replacement (P < 0.05). Blood transfusion rate and day of hospitalization were less in the test group than in the control group (P < 0.05). No significant difference in intraoperative blood loss, pain score and incidence of deep vein thrombosis was detectable between the two groups (P > 0.05). These results indicate that the intravenous drip combined intra-articular injection of tranexamic acid in patients receiving total hip arthroplasty could reduce the amounts of postoperative dominant and hidden blood loss and blood transfusion rate, and did not increase the incidence of deep vein thrombosis.
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Hip, Tranexamic Acid, Blood Loss, Surgical, Tissue Engineering

Zhang Cheng-huan, Liu Yun, Zhao Jian-ning, Meng Jia, Yuan Tao, Bao Ni-rong. Intravenous drip and topical application using tranexamic acid decrease hidden blood loss after total hip arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(44): 7071-7076.

Figures/Tables 7

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