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Blood-Preserving Effect of Tranexamic Acid in Knee Joint Replacement

https://doi.org/10.15360/1813-9779-2008-6-21

Abstract

Objective: to evaluate the efficacy and safety of tranexamic acid in knee joint replacement. Subjects and methods: the prospective open-label study of the efficacy of tranexamic acid as an agent for blood loss reduction in knee joint replacement included 41 patients who were randomly randomized in two groups. Tranexamic acid (Tranexam, ZAO «Mir-Pharm») was injected intravenously in a dose of 15 mg/kg in Group 1 patients just before tourniquet removal, which caused a significant (p=0.003) reduction in drainage losses (from 556 (200; 800) ml to 234 (100; 300) ml) and in the calculated (from the changed concentration on days 3—4 postoperative days) values of overall blood loss (from 1821 (1348; 2156) ml to 1269 (924; 1580) ml (p=0.001) in the immediate postoperative period. There were no tranexamic acid-associated complications. Conclusion: Tranexamic acid is an effective agent in reducing blood loss when the knee joint is replaced. Key words: knee joint replacement, blood loss, tranexamic acid.

References

1. Lemaire R.

2. Ellis M. H., Fredman B., Zohar E. et al.The effect of tourniquet application, tranexamic acid, and desmopressin on the procoagulant and fibrinolytic systems during total knee replacement. J. Clin. Anesth. 2001; 13: 509-513.

3. Mahdy M, Webster N. R.Perioperative systemic haemostatic agents. Br. J. Anaesth. 2004; 93 (6): 842-858.

4. EngelJ. M., Hohaus T., Ruwoldt R. et al.Regional hemostatic status and blood requirements after total knee arthroplasty with and without tranexamic acid or aprotinin. Anesth. Analg. 2001; 92: 775-780.

5. Henry D. A., Carless P. A, Moxey A.J. et al.Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database of Systematic Reviews. 2007; Issue 4.

6. Zufferey P., Merquiol F., Laporte S. et al.Do antifibrinolytics reduce allogeneic blood transfusion in orthopedic surgery? Anesthesiology 2006; 105 (5): 1034-104

7. Nadler S. B., Hidalgo J. U., Bloch T.Prediction of blood volume in normal human adults. Surgery 1962; 51: 224-232.

8. Clinical randomisation of tranexamic acid in significant haemorrhage (CRASH-2)//http://www.hta.ac.uk/1604

9. Hiippala S.Т., Strid L., Wennerstrand M. et al.Tranexamic acid (Cyklokapron) reduces perioperative blood loss associated with total knee arthroplasty. Br. J. Anaesth. 1995; 74: 534-537.

10. Benoni G., Fredin H.Fibrinolytic inhibition with tranexamic acid reduces blood loss and blood transfusion after knee arthroplasty: A prospective, randomised, double-blind study of 86 patients. J. Bone Joint Surg. Br. 1996; 78: 434-440.

11. Benoni G., Fredin H., Knebel R., Nilsson P.Blood conservation with tranexamic acid in total hip arthroplasty: A randomized, double-blind study in 40 primary operations. Acta Orthop Scand. 2001; 72: 442-448.

12. Hiippala S. T., Strid L.J., Wennerstrand M. I. et al.Tranexamic acid radically decreases blood loss and transfusions associated with total knee arthroplasty. Anesth. Analg. 1997; 84: 839-844.

13. Jansen A. J, Andreica S., Claeys M. et al.Use of tranexamic acid for an effective blood conservation strategy after total knee arthroplasty. Br. J. Anaesth. 1999; 83: 596—601.

14. Tanaka N., Sakahashi H., Sato E. et al.Timing of the administration of tranexamic acid for maximum reduction in blood loss in arthroplasty of the knee. J. Bone Joint Surg. Br. 2001; 83: 702—705.

15. Veien M., Sorensen J. V., Madsen F., Juelsgaard P.Tranexamic acid given intraoperatively reduces blood loss after total knee replacement: A randomized, controlled study. Acta Anaesthesiol. Scand. 2002; 46: 1206—1211.

16. Good L., Peterson E., Lisander B.Tranexamic acid decreases external blood loss but not hidden blood loss in total knee replacement. Br. J. Anaesth.2003; 90: 596—599.

17. Zohar E., Ellis M., Ifrach N. et al.The postoperative blood-sparing efficacy of oral versus intravenous tranexamic acid after total knee replacement. Anesth. Analg. 2004; 99: 1679—1683.

18. Alvarez J. C., Santiveri F. X., Ramos I. et al.Tranexamic acid reduces blood transfusion in total knee arthroplasty even when a blood conservation program is applied. Rev. Esp. Anestesiol. Reanim.2008; 55(2): 75—80.

19. Molloy D. O., Archbold H. A. P., Ogonda L. et al.Comparison of topical fibrin spray and tranexamic acid on blood loss after total knee replacement. J. Bone Joint Surg. Br. 2008; 89-B (3): 306—309.

20. Camarasa M., Olle G., Serra-Prat M. et al.Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: a randomized clinical trial. Br. J. Anaesth.2006; 96 (5): 576—582.

21. Ho K., IsmailH.Use of intravenous tranexamic acid to reduce allogene-ic blood transfusion in total hip and knee arthroplasty: a meta-analysis. Anaesth. Intensive Care 2003; 31: 529—537.


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For citations:


Shevchenko Yu.L., Stoiko Yu.M., Zamyatin M.N., Teplykh B.A., Karpov I.A., Smolkin D.A. Blood-Preserving Effect of Tranexamic Acid in Knee Joint Replacement . General Reanimatology. 2008;4(6):21. (In Russ.) https://doi.org/10.15360/1813-9779-2008-6-21

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ISSN 1813-9779 (Print)
ISSN 2411-7110 (Online)