Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplasty

Detalhes bibliográficos
Autor(a) principal: Zekcer,Ari
Data de Publicação: 2017
Outros Autores: Priori,Ricardo Del, Tieppo,Clauber, Silva,Ricardo Soares da, Severino,Nilson Roberto
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista Brasileira de Ortopedia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162017000500589
Resumo: ABSTRACT Objective: To compare topical vs. intravenous tranexamic acid (TA) in total knee arthroplasty regarding blood loss and transfusion., Methods: Ninety patients were randomized to receive TA intravenously (20 mg/kg in 100 mL of saline; group IV), topically (1.5 g in 50 mL of saline, sprayed over the operated site, before release of the tourniquet; topical group), or intravenous saline (100 mL with anesthesia; control group). The volume of drained blood in 48, h, the amount of transfused blood, and the serum levels of hemoglobin and hematocrit before and after surgery were evaluated., Results: The groups were similar for gender, age, weight, laterality, and preoperative hemoglobin and hematocrit levels (p> 0.2). The hemoglobin level dropped in all groups when comparing the preoperative and the 48-h evaluations: the control group decreased 3.8 mg/dL on average, while the IV, group had a decrease of 3.0, and the topical group, of 3.2 (p= 0.019). The difference between the control and IV, groups was confirmed by Bonferroni test (p= 0.020). The difference between the control group and the topical group was not significant (p= 0.130), although there was less reduction in hemoglobin in the topical group; the comparison between the IV, group and the topical group was also not significant (p= 1.000). Conclusion: Using topic and IV, tranexamic acid decreased blood loss and the need for transfusion in total knee arthroplasty. Topical application showed results similar to IV use regarding the need for blood transfusion, but without the possible side effects of IV, administration.
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spelling Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplastyTranexamic acidArthroplastyReplacement arthroplastyKneeFibrin modulating agentsAntifibrinolyticABSTRACT Objective: To compare topical vs. intravenous tranexamic acid (TA) in total knee arthroplasty regarding blood loss and transfusion., Methods: Ninety patients were randomized to receive TA intravenously (20 mg/kg in 100 mL of saline; group IV), topically (1.5 g in 50 mL of saline, sprayed over the operated site, before release of the tourniquet; topical group), or intravenous saline (100 mL with anesthesia; control group). The volume of drained blood in 48, h, the amount of transfused blood, and the serum levels of hemoglobin and hematocrit before and after surgery were evaluated., Results: The groups were similar for gender, age, weight, laterality, and preoperative hemoglobin and hematocrit levels (p> 0.2). The hemoglobin level dropped in all groups when comparing the preoperative and the 48-h evaluations: the control group decreased 3.8 mg/dL on average, while the IV, group had a decrease of 3.0, and the topical group, of 3.2 (p= 0.019). The difference between the control and IV, groups was confirmed by Bonferroni test (p= 0.020). The difference between the control group and the topical group was not significant (p= 0.130), although there was less reduction in hemoglobin in the topical group; the comparison between the IV, group and the topical group was also not significant (p= 1.000). Conclusion: Using topic and IV, tranexamic acid decreased blood loss and the need for transfusion in total knee arthroplasty. Topical application showed results similar to IV use regarding the need for blood transfusion, but without the possible side effects of IV, administration.Sociedade Brasileira de Ortopedia e Traumatologia2017-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162017000500589Revista Brasileira de Ortopedia v.52 n.5 2017reponame:Revista Brasileira de Ortopedia (Online)instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)instacron:SBOT10.1016/j.rboe.2017.08.005info:eu-repo/semantics/openAccessZekcer,AriPriori,Ricardo DelTieppo,ClauberSilva,Ricardo Soares daSeverino,Nilson Robertoeng2017-11-10T00:00:00Zoai:scielo:S0102-36162017000500589Revistahttp://www.rbo.org.br/https://old.scielo.br/oai/scielo-oai.php||rbo@sbot.org.br1982-43780102-3616opendoar:2017-11-10T00:00Revista Brasileira de Ortopedia (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)false
dc.title.none.fl_str_mv Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplasty
title Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplasty
spellingShingle Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplasty
Zekcer,Ari
Tranexamic acid
Arthroplasty
Replacement arthroplasty
Knee
Fibrin modulating agents
Antifibrinolytic
title_short Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplasty
title_full Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplasty
title_fullStr Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplasty
title_full_unstemmed Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplasty
title_sort Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplasty
author Zekcer,Ari
author_facet Zekcer,Ari
Priori,Ricardo Del
Tieppo,Clauber
Silva,Ricardo Soares da
Severino,Nilson Roberto
author_role author
author2 Priori,Ricardo Del
Tieppo,Clauber
Silva,Ricardo Soares da
Severino,Nilson Roberto
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Zekcer,Ari
Priori,Ricardo Del
Tieppo,Clauber
Silva,Ricardo Soares da
Severino,Nilson Roberto
dc.subject.por.fl_str_mv Tranexamic acid
Arthroplasty
Replacement arthroplasty
Knee
Fibrin modulating agents
Antifibrinolytic
topic Tranexamic acid
Arthroplasty
Replacement arthroplasty
Knee
Fibrin modulating agents
Antifibrinolytic
description ABSTRACT Objective: To compare topical vs. intravenous tranexamic acid (TA) in total knee arthroplasty regarding blood loss and transfusion., Methods: Ninety patients were randomized to receive TA intravenously (20 mg/kg in 100 mL of saline; group IV), topically (1.5 g in 50 mL of saline, sprayed over the operated site, before release of the tourniquet; topical group), or intravenous saline (100 mL with anesthesia; control group). The volume of drained blood in 48, h, the amount of transfused blood, and the serum levels of hemoglobin and hematocrit before and after surgery were evaluated., Results: The groups were similar for gender, age, weight, laterality, and preoperative hemoglobin and hematocrit levels (p> 0.2). The hemoglobin level dropped in all groups when comparing the preoperative and the 48-h evaluations: the control group decreased 3.8 mg/dL on average, while the IV, group had a decrease of 3.0, and the topical group, of 3.2 (p= 0.019). The difference between the control and IV, groups was confirmed by Bonferroni test (p= 0.020). The difference between the control group and the topical group was not significant (p= 0.130), although there was less reduction in hemoglobin in the topical group; the comparison between the IV, group and the topical group was also not significant (p= 1.000). Conclusion: Using topic and IV, tranexamic acid decreased blood loss and the need for transfusion in total knee arthroplasty. Topical application showed results similar to IV use regarding the need for blood transfusion, but without the possible side effects of IV, administration.
publishDate 2017
dc.date.none.fl_str_mv 2017-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.relation.none.fl_str_mv 10.1016/j.rboe.2017.08.005
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Ortopedia e Traumatologia
publisher.none.fl_str_mv Sociedade Brasileira de Ortopedia e Traumatologia
dc.source.none.fl_str_mv Revista Brasileira de Ortopedia v.52 n.5 2017
reponame:Revista Brasileira de Ortopedia (Online)
instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)
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repository.name.fl_str_mv Revista Brasileira de Ortopedia (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)
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