• Int J Surg · May 2019

    Randomized Controlled Trial

    The efficacy and safety of multiple doses of oral tranexamic acid on blood loss, inflammatory and fibrinolysis response following total knee arthroplasty: A randomized controlled trial.

    • Yanfeng Tang, Yangyang Wen, Wuyin Li, Hongjun Li, Yuxia Yang, and Youwen Liu.
    • Department of Orthopedics, Luoyang Zhenggu Hospital of Henan province(Henan Orthopedic Hospital), Luoyang, Henan Province, 471000, China. Electronic address: Yanfengt@163.com.
    • Int J Surg. 2019 May 1; 65: 45-51.

    BackgroundThe aim of the study was to identify the efficacy and safety of multiple doses of oral tranexamic acid (TXA) on reducing blood loss and minimizing the postoperative inflammatory and fibrinolytic responses following primary total knee arthroplasty (TKA).Materials And MethodsIn this prospective, double-blinded, randomized trial, we randomly assigned a total of 151 patients into three groups to receive 2 g of oral TXA 2 h preoperatively (group A); an additional dose of 2 g of oral TXA 4 h postoperatively (group B); or additional doses of 2 g of oral TXA at 4, 10, and 16 h postoperatively (group C). The primary outcome was total blood loss (TBL). The secondary outcomes were maximum drop in hemoglobin (Hb) and hematocrit (Hct), level of inflammatory and fibrinolytic parameters, transfusion rate, and the incidence of complications.ResultsThe results were represented as mean ± standard deviation. The mean TBL was 607 ± 254 mL in group C, 743 ± 347 mL in group B (p = 0.027 vs group C), and 978 ± 335 mL in group A (p<0.001 vs group C). The maximum Hb and Hct drop was 18.3 ± 7.7 g/L and 0.051 ± 0.025 in group C, 22.3 ± 9.7 g/L and 0.070 ± 0.028 in group B (p = 0.022 and p = 0.001 vs group C), 29.6 ± 11.7 g/L and 0.090 ± 0.034 in group A (p<0.001 and p<0.001 vs group C). In addition, C-reactive protein and interleukin-6 in group C were lower than in group A (p<0.001 and p = 0.003) and in group B (p = 0.031 and p < 0.001) on postoperative day (POD) 3. Moreover, fibrin degradation products and D-dimer in group C were lower than in groups A and B on both POD 1 and POD 3. The incidence of complications did not differ significantly between the three groups (p > 0.05).ConclusionMultiple postoperative doses of oral TXA could further reduced blood loss and the drop in Hb and Hct, and diminished the postoperative inflammatory and fibrinolytic responses in primary TKA with no apparent increase in the incidence of complications.Level Of EvidenceLevel Ⅰ, therapeutic study.Copyright © 2019 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…