Background: Peri-operative bleeding is one of the major indication for allogenic blood transfusion. To reduce Post-operative blood loss, a number of antifibrinolytic agents like tranexamic acid have been used, which act by competitive inhibition of plasminogen.

Aims and Objectives: To assess the role of tranexamic acid in reducing blood loss and transfusion in patients undergoing knee arthroplasty.

Materials and Methods: A prospective randomized study was conducted on 60 patients who underwent bicondylar cemented knee arthroplasty. All the patients were randomly allocated in to two groups, Group A (n=30): receiving TXA 10 mg/Kg, 30 minutes before the release of tourniquet followed by an inflation of 1 mg/Kg/hour for 12 hours, whereas group B (n=30) did not received any treatment for prevention of blood loss. During surgery, blood loss was assessed, the contents of drain were measured and recorded and the number of units of blood transfused during the perioperative period and five days postoperatively was recorded and any complications were also documented.

Results: The intraoperative blood loss was similar in both the groups, whereas there was a statistical difference between both the groups in respect to post intraoperative blood loss and total blood loss. 40% controls required blood transfusion compared to only 20% TA patients required blood transfusion i.e. 50% reduction in requirement.

Conclusion: Tranexamic acid can be safely advocated for knee arthroplasty as an effective strategy to reduce perioperative blood loss and it minimizes the need for blood transfusion. 

Keywords: Blood transfusion, Fibrin, Knee Arthroplasty, Plasminogen, Tranexamic acid.

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Dr Ratnam Raoji

Associate Professor, Department of Anaesthesiology, Prathima Institute of Medical Sciences, Karimnagar, Telangana, India