Effect of tranexamic acid combined with carbazochrome sodium sulfonate on blood loss and safety after total knee arthroplasty

doi:10.3969/j.issn.2095-4344.2948

Abstract

Abstract: BACKGROUND: The application of tranexamic acid in knee and hip arthroplasty can reduce blood loss safely and effectively. As a kind of hemostatic agent for strengthening blood vessels, the hemostasis process of carbazochrome sodium sulfonate does not depend on the coagulation system of human body, so it has better security.
OBJECTIVE: To explore the safety and blood loss of tranexamic acid combined with carbazochrome sodium sulfonate in total knee arthroplasty.
METHODS: From July 2018 to December 2019, 67 patients with knee osteoarthritis were selected from the Affiliated Hospital of Xuzhou Medical University, including 18 males and 49 females. They were randomly divided into two groups. The observation group (n=32) received intravenous injection of tranexamic acid before total knee arthroplasty, followed by intravenous injection of carbazochrome sodium sulfonate after total knee arthroplasty. The control group (n=35) received intravenous injection of tranexamic acid before total knee arthroplasty, followed by intravenous injection of saline after total knee arthroplasty. The total blood loss, hidden blood loss, maximum hemoglobin drop, blood transfusion rate, incidence of thrombotic events (lower limb intermuscular vein thrombosis, deep vein thrombosis and pulmonary embolism), perioperative fibrinolytic parameters (fibrin and fibrinogen degradation products, D-dimer), inflammation markers (C-reactive protein, interleukin-6) were compared between the two groups. The study was approved by Medical Ethics Committee of Affiliated Hospital of Xuzhou Medical University.
RESULTS AND CONCLUSION: (1) The decrease of total blood loss, hidden blood loss and maximum hemoglobin drop in the observation group was less than those in the control group (P < 0.05). (2) The levels of fibrin and fibrinogen degradation products, D-dimer in the observation group 1 day after surgery were lower than those in the control group (P < 0.05), and there was no significant difference between the two groups on day 3 after operation (P > 0.05). (3) The C-reactive protein level of the observation group was lower than that of the control group on day 1 and day 3 after surgery (P < 0.05), and the level of interleukin-6 on day 1 after surgery was lower than that of the control group (P < 0.05). There was no significant difference in the level of interleukin-6 between the two groups on day 3 after surgery (P > 0.05). (4) There was no blood transfusion, deep venous thrombosis of lower limbs or pulmonary embolism in the two groups during their hospitalization. (5) The results showed that tranexamic acid combined with carbazochrome sodium sulfonate can further reduce the total blood loss, hidden blood loss and hemoglobin drop of patients after total knee arthroplasty, reduce the inflammatory reaction, and do not increase the risk of thrombosis, so it was safe.

Key words: bone, prosthesis, implant, joint arthroplasty, knee, tranexamic acid, carbazochrome sodium sulfonate, blood loss

CLC Number:

Lü Zexiang, Wu Jutai, Jiang Jian, Feng Xiao, Li Tengfei, Wang Yehua. Effect of tranexamic acid combined with carbazochrome sodium sulfonate on blood loss and safety after total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(3): 386-390.

Figures/Tables 4

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