Comparison of two doses of intra-articular tranexamic acid on postoperative bleeding in total knee arthroplasty : a randomized clinical trial
Copyright © 2020 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved..
INTRODUCTION: Tranexamic Acid (TXA), an antifibrinolytic that inhibits the fibrinolytic activity of plasmin is used to decrease perioperative blood loss and transfusion requirements in orthopedic surgery. The aim of our study was to compare postoperative bleeding in two intra-articular doses (1g and 2g) of tranexamic acid in adult patients undergoing unilateral total knee replacement.
METHOD: We conducted a single-operator, randomized, and controlled, double-blind study in two groups. The G1 group received 1g of intra-articular TXA and the G2 group 2g of intra-articular TXA. Both groups received 15mg.kg-1 IV before the surgical incision (TXA induction dose) and then 10mg.kg-1, orally, 6 and 12hours after the induction dose of TXA. The primary endpoint was bleeding measured by blood loss in postoperative drainage. Secondary outcomes were change in hemoglobin and hematocrit levels on the first and third postoperative days, and the need for transfusion during hospitalization.
RESULTS: In total, 100 patients were randomized, and 100 were included in the analysis. Blood loss in postoperative drainage was similar in both groups (200±50 vs. 250±50mL, G1 and G2 groups respectively). Change in hematocrit and hemoglobin values (% of change) between preoperative and day 3 were not statically significant between groups G1 and G2 (18±5 vs. 21±4; 21±7 vs. 22±5 respectively). No patients received blood transfusion.
CONCLUSIONS: Our study did not show superiority of 2g of intra-articular tranexamic acid compared to 1g. ClinicalTrials.gov Identifier NCT04085575.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:70 |
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| Enthalten in: |
Brazilian journal of anesthesiology (Elsevier) - 70(2020), 4 vom: 29. Juli, Seite 318-324 |
| Sprache: |
Portugiesisch |
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| Weiterer Titel: |
Comparação entre duas doses de ácido tranexâmico intra‐articular no sangramento pós‐operatório de artroplastia total do joelho: estudo clínico randomizado |
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| Beteiligte Personen: |
Souza Neto, Edmundo Pereira de [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 22.07.2021 Date Revised 16.08.2022 published: Print-Electronic ClinicalTrials.gov: NCT04085575 Citation Status MEDLINE |
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| doi: |
10.1016/j.bjan.2020.03.015 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM313934843 |
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| 245 | 1 | 0 | |a Comparison of two doses of intra-articular tranexamic acid on postoperative bleeding in total knee arthroplasty |b a randomized clinical trial |
| 246 | 3 | 3 | |a Comparação entre duas doses de ácido tranexâmico intra‐articular no sangramento pós‐operatório de artroplastia total do joelho: estudo clínico randomizado |
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| 500 | |a Date Revised 16.08.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT04085575 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved. | ||
| 520 | |a INTRODUCTION: Tranexamic Acid (TXA), an antifibrinolytic that inhibits the fibrinolytic activity of plasmin is used to decrease perioperative blood loss and transfusion requirements in orthopedic surgery. The aim of our study was to compare postoperative bleeding in two intra-articular doses (1g and 2g) of tranexamic acid in adult patients undergoing unilateral total knee replacement | ||
| 520 | |a METHOD: We conducted a single-operator, randomized, and controlled, double-blind study in two groups. The G1 group received 1g of intra-articular TXA and the G2 group 2g of intra-articular TXA. Both groups received 15mg.kg-1 IV before the surgical incision (TXA induction dose) and then 10mg.kg-1, orally, 6 and 12hours after the induction dose of TXA. The primary endpoint was bleeding measured by blood loss in postoperative drainage. Secondary outcomes were change in hemoglobin and hematocrit levels on the first and third postoperative days, and the need for transfusion during hospitalization | ||
| 520 | |a RESULTS: In total, 100 patients were randomized, and 100 were included in the analysis. Blood loss in postoperative drainage was similar in both groups (200±50 vs. 250±50mL, G1 and G2 groups respectively). Change in hematocrit and hemoglobin values (% of change) between preoperative and day 3 were not statically significant between groups G1 and G2 (18±5 vs. 21±4; 21±7 vs. 22±5 respectively). No patients received blood transfusion | ||
| 520 | |a CONCLUSIONS: Our study did not show superiority of 2g of intra-articular tranexamic acid compared to 1g. ClinicalTrials.gov Identifier NCT04085575 | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Artroplastia total do joelho | |
| 650 | 4 | |a Hemorragia | |
| 650 | 4 | |a Hemorrhage | |
| 650 | 4 | |a Hemostasia | |
| 650 | 4 | |a Hemostasis | |
| 650 | 4 | |a Intravenosa | |
| 650 | 4 | |a Intravenous | |
| 650 | 4 | |a Intra‐articular | |
| 650 | 4 | |a Topical | |
| 650 | 4 | |a Total knee arthroplasty | |
| 650 | 4 | |a Tranexamic acid | |
| 650 | 4 | |a Tópico | |
| 650 | 4 | |a Ácido tranexâmico | |
| 650 | 7 | |a Antifibrinolytic Agents |2 NLM | |
| 650 | 7 | |a Hemoglobins |2 NLM | |
| 650 | 7 | |a Tranexamic Acid |2 NLM | |
| 650 | 7 | |a 6T84R30KC1 |2 NLM | |
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