Analysis of Efficacy of Tranexamic Acid in Reduction of Blood Loss and Postoperative Blood Transfusions Following Orthopedic Trauma Surgery

Perioperative and postsurgical hemorrhage is common in invasive surgical procedures, including orthopedic surgery. Tranexamic acid (TXA) is a pharmacologic agent that acts through an antifibrinolytic mechanism to stabilize formed clots and to reduce active bleeding. It has been used successfully in orthopedics to reduce perioperative blood loss, particularly in total hip and knee arthroplasty and spine surgery. Ischemia increases fibrinolysis, related to the proteolytic action of plasmin, with a subsequent fibrinogen scission, which limits postoperative coagulation and favors bleeding. Tranexamic acid being antifibrinolytic acts to prevent this effect from taking place. This study was designed to assess the efficacy of TXA in reducing blood loss and postoperative blood transfusions following the fixation of fracture of both bones of leg with intramedullary interlocking nailing of tibia done by open method. Randomized, prospective, comparative study. In this study, patients were randomly allocated into two groups of 25 each. Group I received inj. TXA and group II received inj. normal saline. Preoperative hemoglobin (Hb), postoperative Hb, total blood volume (BV), blood loss, and Hb loss were compared between two groups. Statistical analysis was done with Fisher's t test and Fisher's exact test. The mean blood loss in TXA and placebo group was 249.02 ± 57.04 mL and 543 ± 83.64 mL, respectively, and found to be highly significant (p value < 0.001). A number of patients required blood transfusion were significantly low in TXA group than in placebo group (p < 0.01). This study indicated that TXA results in significant reduction in blood loss (nearly 60%) and amount of blood transfusion required in patients undergoing surgery. Routine administration of TXA may benefit patients undergoing surgery where significant blood loss is expected. Kingsly P, Sathish M, Ismail NMDM. Analysis of Efficacy of Tranexamic Acid in Reduction of Blood Loss and Postoperative Blood Transfusions Following Orthopedic Trauma Surgery. J Orth Joint Surg 2019;1(1):27–30.