Efficacy of combined use of intravenous and intra-articular versus intra-articular tranexemic acid in blood loss in primary total knee arthroplasty: A randomized controlled study

Q4 Medicine
Yeshi Dorji, Chandra M. Singh, Anil K. Mishra, Ajay Deep Sud
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Abstract

Purpose/objectives

This study was conducted to compare the efficacy of preoperative intravenous (IV) and intraoperative topical administration of tranexamic acid versus intraoperative topical administration of tranexamic acid along in reducing blood loss in primary total knee arthroplasty (TKA) subjects. The hypothesis of this study was the combined use of intravenous and Intra-articular injection of Tranexamic acid will be more efficacious than intra-articular administration alone in reducing blood loss in Primary Total Knee Arthroplasty.

Materials and method

A total of 31 subjects were selected and randomized into intervention and control group. The intervention group received both intravenous and intra articular tranexamic acid i.e. Trenexamic acid 1 gm IV injection 15 min before skin incision and Trenexamic acid 1 gm intra articular application intraoperatively after joint capsule closure. Subjects in the control group received only intra articular tranexamic acid i.e. Trenexamic acid 1 gm in 20 ml normal saline using intra articular application after joint capsule closure. Outcome measurements included postoperative surgical site drain output, drop in haemoglobin levels and transfusion rate. Ethics approval was taken from the Medical Research Unit, Armed Forces Medical College, Pune.

Results

The mean total blood (drain output) in the intervention group was 354.5 (±208.22) ml vs. 397.65 (±125.00) ml in the control group. T-test between the two groups on the volume drained post-operatively was not significant (p = 0.482). No subjects in the intervention group required post-operative blood transfusion but one subject from the control group required blood transfusion.

Conclusion

Combined use of intravenous and intraarticular injection tranexamic acid had lesser surgical site bleeding compared to only topical administration, however this was not statistically significant.

首次全膝关节置换术中联合使用静脉和关节内与关节内联合使用tranisic酸治疗失血的疗效:一项随机对照研究
目的/目的本研究旨在比较术前静脉(IV)和术中局部给药氨甲环酸与术中局部给药氨甲环酸在减少原发性全膝关节置换术(TKA)患者出血量方面的疗效。本研究的假设是在原发性全膝关节置换术中,静脉和关节内联合注射氨甲环酸比关节内单独给药更有效地减少失血量。材料与方法选取31例受试者,随机分为干预组和对照组。干预组同时静脉注射氨甲环酸和关节内注射氨甲环酸,即切开皮肤前15 min静脉注射氨甲环酸1 gm,术中关节囊闭合后应用氨甲环酸1 gm。对照组患者在关节囊闭合后仅关节内应用氨甲环酸,即氨甲环酸1 gm加入生理盐水20 ml中。结果测量包括术后手术部位引流量、血红蛋白水平下降和输血率。道德规范得到了浦那武装部队医学院医学研究股的批准。结果干预组平均总血(排血量)为354.5(±208.22)ml,对照组为397.65(±125.00)ml。两组术后引流量的t检验差异无统计学意义(p = 0.482)。干预组无患者术后输血,对照组1例患者术后输血。结论静脉联合关节内注射氨甲环酸与单纯局部给药相比,手术部位出血较少,但差异无统计学意义。
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来源期刊
Journal of Arthroscopy and Joint Surgery
Journal of Arthroscopy and Joint Surgery Medicine-Orthopedics and Sports Medicine
CiteScore
0.60
自引率
0.00%
发文量
1
期刊介绍: Journal of Arthroscopy and Joint Surgery (JAJS) is committed to bring forth scientific manuscripts in the form of original research articles, current concept reviews, meta-analyses, case reports and letters to the editor. The focus of the Journal is to present wide-ranging, multi-disciplinary perspectives on the problems of the joints that are amenable with Arthroscopy and Arthroplasty. Though Arthroscopy and Arthroplasty entail surgical procedures, the Journal shall not restrict itself to these purely surgical procedures and will also encompass pharmacological, rehabilitative and physical measures that can prevent or postpone the execution of a surgical procedure. The Journal will also publish scientific research related to tissues other than joints that would ultimately have an effect on the joint function.
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