• Alejandro Reyes-Sánchez, Alejandro Domínguez-Soto, Barón Zárate-Kalfópulos, Javier Guerra-Garza, Rocio Gordillo-Pérez, Curtis Huffman, Luis M Rosales-Olivarez, Armando Alpízar-Aguirre, and Carla L García-Ramos.
• Spine Surgery Division, National Institute of Rehabilitation, Mexico City, Mexico.
• World Neurosurg. 2023 Jul 1; 175: e964e968e964-e968.

ObjectiveTo evaluate the efficacy of oral administration of tranexamic acid (TXA) in spine surgery to achieve blood loss reduction.MethodsSixty patients undergoing major surgery of the spine were randomly assigned into 2 groups. Group 1 was assigned as the control group and the other group comprised patients who received oral administration of TXA 2 hours before surgery. Outcome measures included intraoperative blood loss, postoperative blood loss, hematologic parameters, blood transfusion needed, and surgical complications.ResultsSixty patients linked up with the inclusion criteria. Intraoperative blood loss was significantly lower in the TXA oral group than in the control group; total blood loss in the TXA group was 930.66 ± 614 mL, which was lower than in the control group, with 1075.66 ± 956.11 mL. The mean reduction of hemoglobin was almost the same in both groups. Similarly, the total transfusion package received was lower, and the number of complications and length of stay were akin in both groups. A logistic regression model was performed with patients who had blood loss >1000 mL and surgery time >230 minutes. This result was related to the risk of bleeding, with an odds ratio of 1.31, 95% confidence interval, 1.004-1.023, P = 0.004, independent of the group.ConclusionsOral TXA is as an effective measure for reducing total blood loss among patients undergoing elective spine surgery.Copyright © 2023 Elsevier Inc. All rights reserved.

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