Association of single bolus versus bolus followed by infusion of tranexamic acid with blood loss in adolescent idiopathic scoliosis surgery.

IF 2 3区医学 Q2 ANESTHESIOLOGY

Perioperative Medicine Pub Date : 2024-09-30 DOI:10.1186/s13741-024-00452-1

Mohd Shahnaz Hasan, Mew Har Leong, Zheng-Yii Lee, Chee Kidd Chiu, Chris Yin Wei Chan, Mun Keong Kwan, Siti Nadzrah Yunus

{"title":"Association of single bolus versus bolus followed by infusion of tranexamic acid with blood loss in adolescent idiopathic scoliosis surgery.","authors":"Mohd Shahnaz Hasan, Mew Har Leong, Zheng-Yii Lee, Chee Kidd Chiu, Chris Yin Wei Chan, Mun Keong Kwan, Siti Nadzrah Yunus","doi":"10.1186/s13741-024-00452-1","DOIUrl":null,"url":null,"abstract":"Background: Adolescent idiopathic scoliosis (AIS) corrective surgery may involve significant blood loss and blood transfusion requirements. Antifibrinolytic agents such as tranexamic acid (TXA) have been used to reduce blood loss, but its optimal dose is uncertain. The objective of this study is to determine the estimated blood loss and rate of blood transfusion between two groups of AIS patients receiving TXA as a single bolus versus bolus followed by infusion in scoliosis surgery.Methods: This was a retrospective analysis of a single bolus versus bolus followed by infusion of TXA in AIS surgery. AIS patients undergoing posterior spinal fusion (PSF) from December 2018 to September 2019 at a tertiary university hospital were identified. Inclusion criteria were patients aged between 10 and 21 years who received either a single bolus of 30 mg/kg TXA (Group A) or a single bolus of 30 mg/kg followed by continuous infusion of 10 mg/kg/h of TXA (Group B). Patient demographics, operative data, estimated blood loss, blood transfusion rate, and complications were recorded.Results: A total of 129 AIS patients were included. All operative surgeries were performed by two senior consultants. The mean age was 14.8 ± 3.4 years old, and 89.1% were female. The Cobb angle, number of fusion levels, number of screws, length of skin incision, and duration of surgery were comparable between the two groups. There was no difference in the total estimated blood loss between the two groups: 723.3 ± 279.4 mL (range: 175.0-1607.0 mL) in Group A and 819.4 ± 302.6 mL (range: 330.0-1556.0 mL) in Group B (p = 0.065). There were no complications, and none received blood transfusion.Conclusion: TXA when administered as a single bolus or bolus followed by infusion in AIS patients undergoing PSF surgery was associated with similar estimated total surgical blood loss and blood transfusion requirement.","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"13 1","pages":"94"},"PeriodicalIF":2.0000,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443673/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Perioperative Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13741-024-00452-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Adolescent idiopathic scoliosis (AIS) corrective surgery may involve significant blood loss and blood transfusion requirements. Antifibrinolytic agents such as tranexamic acid (TXA) have been used to reduce blood loss, but its optimal dose is uncertain. The objective of this study is to determine the estimated blood loss and rate of blood transfusion between two groups of AIS patients receiving TXA as a single bolus versus bolus followed by infusion in scoliosis surgery.

Methods: This was a retrospective analysis of a single bolus versus bolus followed by infusion of TXA in AIS surgery. AIS patients undergoing posterior spinal fusion (PSF) from December 2018 to September 2019 at a tertiary university hospital were identified. Inclusion criteria were patients aged between 10 and 21 years who received either a single bolus of 30 mg/kg TXA (Group A) or a single bolus of 30 mg/kg followed by continuous infusion of 10 mg/kg/h of TXA (Group B). Patient demographics, operative data, estimated blood loss, blood transfusion rate, and complications were recorded.

Results: A total of 129 AIS patients were included. All operative surgeries were performed by two senior consultants. The mean age was 14.8 ± 3.4 years old, and 89.1% were female. The Cobb angle, number of fusion levels, number of screws, length of skin incision, and duration of surgery were comparable between the two groups. There was no difference in the total estimated blood loss between the two groups: 723.3 ± 279.4 mL (range: 175.0-1607.0 mL) in Group A and 819.4 ± 302.6 mL (range: 330.0-1556.0 mL) in Group B (p = 0.065). There were no complications, and none received blood transfusion.

Conclusion: TXA when administered as a single bolus or bolus followed by infusion in AIS patients undergoing PSF surgery was associated with similar estimated total surgical blood loss and blood transfusion requirement.

查看原文本刊更多论文

在青少年特发性脊柱侧凸手术中，氨甲环酸单次栓塞与栓塞后输注与失血量的关系。

背景：青少年特发性脊柱侧凸（AIS）矫正手术可能会导致大量失血和输血需求。氨甲环酸（TXA）等抗纤维蛋白溶解剂已被用于减少失血，但其最佳剂量尚不确定。本研究的目的是确定脊柱侧弯手术中两组接受氨甲环酸（TXA）单次栓注与栓注后输注的AIS患者的估计失血量和输血率：这是一项对AIS手术中单次栓注TXA与栓注后输注TXA的回顾性分析。确定了 2018 年 12 月至 2019 年 9 月在一家三级大学医院接受脊柱后路融合术（PSF）的 AIS 患者。纳入标准为年龄在10至21岁之间，接受单次栓注30毫克/千克TXA（A组）或单次栓注30毫克/千克后持续输注10毫克/千克/小时TXA（B组）的患者。记录了患者的人口统计学特征、手术数据、估计失血量、输血率和并发症：结果：共纳入 129 名 AIS 患者。所有手术均由两名资深顾问实施。平均年龄为（14.8±3.4）岁，89.1%为女性。两组患者的 Cobb 角、融合层次数、螺钉数量、皮肤切口长度和手术持续时间相当。两组的估计总失血量没有差异：A 组为 723.3 ± 279.4 mL（范围：175.0-1607.0 mL），B 组为 819.4 ± 302.6 mL（范围：330.0-1556.0 mL）（P = 0.065）。没有出现并发症，也没有人接受输血：结论：在接受 PSF 手术的 AIS 患者中，以单次给药或给药后输注 TXA 的估计手术总失血量和输血需求相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Perioperative Medicine Multiple-

自引率

3.80%

发文量

审稿时长

10 weeks