• Reno E Tilgreen Nielsen and Henrik Husted.
• H:S Hvidovre Hospital, ortopaedkirurgisk afdeling 333.
• Ugeskr. Laeg. 2002 Jan 14;164(3):326-9.

AbstractAlready, four relevant prospective, randomised studies have shown a reduction of about 50% in both the postoperative blood loss and the need for blood transfusion on the first postoperative day in patients who received prophylactic TXA when operated on for a total knee replacement. The initial dose should be given about 10-15 minutes before the tourniquet is released, the reason being that the incidence of DVT at this time has not been sufficiently documented when TXA is given before the tourniquet is applied. In these studies, increased incidence of DVT has not been found in the TXA group, although the patients were only examined clinically. The best effect is thought to be accomplished with a bolus of 10-15 mg/kg, eventually repeated every 6-8 hours during the first postoperative day. A repeat dose, however, seems to decrease the total postoperative blood loss only marginally. Tranexamic acid reduces postoperative bleeding and the need for transfusion during knee replacement.

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