A Comparison of the Use of Tranexamic Acid versus Placebo in Patients Undergoing Excision of Intracranial Meningioma

Objective:  Complete surgical removal of intracranial meningiomas is curative but with significant blood loss. Tranexamic acid has been proven beneficial in reducing blood loss following major surgical procedures. Therefore, the purpose of the study was to evaluate how well tranexamic acid worked to stop blood loss in patients having an intracranial meningioma removed. Objective:  This study compares the effects of tranexamic acid and placebo on intraoperative blood loss, transfusion needs, and the frequency of surgical sites with good hemostatic quality in patients having an intracranial meningioma removed. Materials & Methods:  This clinical trial was carried out in the Department of Neurosurgery, unit II PGMI/ PINS, Lahore over 1 year. Two equal groups of 30 individuals each were formed from a total of 60 patients having an intracranial meningioma diagnosis. Group 1 was given TXA, whereas Group 2 was given a placebo (normal saline). Patients were assessed for intraoperative blood loss, transfusion needs, and a clean surgical area in terms of hemostasis. Results:  Mean blood loss in the TXA group was 803.0 ± 106.53mL while that in the placebo group was 1159.5 ± 101.79 mL which was statistically significant (p = 0.000). TXA also significantly reduced transfusion requirements (p = 0.000) and was associated with better hemostasis of the surgical field (p = 0.000). Conclusion:  This study concluded that TXA can reduce intraoperative blood loss and decrease the transfusion requirements in the postoperative period significantly as compared to placebo in patients experiencing surgical intracranial meningioma excision.