Abstract

Background: Major orthopedic procedures including total knee replacement, hip replacement, and spine surgeries are associated with severe bleeding because of extensive dissection through bony and fibrotic tissue, increased fibrinolysis due to tourniquet application, surgery and inability to cauterize bleeding bony surfaces. This study aims on the efficacy and safety of tranexamic acid which is an antifibrinolytic agent that decreases total blood loss in the prevention of bleeding in total knee replacement.

Materials and Methods: This Randomised Double Blind Controlled Clinical Trial was conducted after obtaining approval of Research methodology and institutional ethics committee and written informed consent from all patients. Adult patients of ASA I and II Class, of age 30-60yrs, satisfying the selection criteria, undergoing elective TKR surgery were selected and randomly allocated into two groups, Group 1 TU: Unilateral TKR patients received tranexamic acid 10 mg/kg intravenously before the tourniquet applications followed by 1 mg/kg/hour till the end of the surgery and Group 2, CU: Unilateral TKR patients not received tranexamic  acid .Blood loss was measured in the post operative period after 4 hours and 24 hours.

Results: The two groups were comparable in terms of age, gender, preoperative Hb (gm/dl), PCV (%) and duration of surgery. A statistically significant reduction in blood loss by more than 65% was observed in patients who received tranexamic acid.

Conclusion: The observation of this study shows that tranexamic acid can significantly reduce perioperative blood loss without any side effects in patients undergoing total knee replacement.

Keywords: Total knee replacement, Tranexamic acid, Blood loss.

Dr Sobha S

Additional Professor, Dept of Anesthesiology

Government Medical College, Thiruvananthapuram