Comparative Study Of Tourniquet V/S Tranexamic Acid Use On Blood Loss In Total Knee Arthroplasty
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2017, Vol 3, Issue 1
Abstract
Context: Total knee replacement (TKR) is often carried out using a tourniquet to minimize intraoperative blood loss. However, its application enhances local fibrinolysis, resulting in excessive blood loss during the post-operative period. Fibrinolytic profile varies in different regions and races. Tranexamic acid has been shown to reduce post¬operative blood loss and the need for transfusion in TKR. However, there is paucity of literature from the Indian population and the efficacy of the agent has not been tested in Indian patients undergoing TKR. Aims: Effect of tranexamic acid without use of tourniquet V/S tourniquet use on blood loss in TKR surgery in the Indian population. Setting and Design: In this study, 40 patients undergoing unilateral TKR were randomly divided into two groups. Methods: All patients were conducted under spinal anaesthesia using injection bupivacaine 0.5% heavy 12-15 mg.One group received 10 mg/kg tranexamic acid, intravenous (IV), half an hour before deflation of the tourniquet without use of tourniquet, with a second dose of 2-mg/kg administered 3 hours after the first dose.Other group underwent TKR under tourniquet which was inflated before surgey and deflated after compression bandage at the end of procedure. Blood loss, blood transfusion details and change in haemoglobin levels were noted. Results: The mean total-operative blood loss in the tranexamic acid group was 1720ml and 1795 ml in the tourniquet group. The absolute number of blood transfusions and the number of patients who required transfusions were lower in the tranexamic acid group than in the tourniquet group. None of the patients had any side or adverse effect. Conclusions:Tranexamic acid significantly decreases post-operative blood loss and reduces the need for blood transfusion in patients undergoing TKR.
Authors and Affiliations
Baljit Singh, Shaleen Sareelk, Gurminder Singh, Parampreet Singh
Keywords
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