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Abdou M, Kwon JW, Kim HJ, Lee B, Choi YS, Moon SH, Lee BH. Tranexamic Acid and Intraoperative and Postoperative Accumulative Bleeding in Elective Degenerative Spine Surgery. Yonsei Med J 2022; 63:927-932. [PMID: 36168245 PMCID: PMC9520043 DOI: 10.3349/ymj.2022.0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/07/2022] [Accepted: 08/02/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Spinal surgeries are often associated with a high incidence of perioperative blood loss, which poses several complications. Much current research focuses on the importance of antifibrinolytic drugs during spinal surgeries to reduce blood loss, which can also reduce the risk of the need for blood transfusions. We evaluated the effects of prophylactic, low-dose tranexamic acid (TXA) in spinal fusion surgeries on blood loss, blood transfusions, and associated complications. MATERIALS AND METHODS TXA was administered to 90 patients at a constant infusion rate of 10 mg/kg for 20 minutes after anesthesia induction, followed by a maintenance dose of 1 mg/kg/h until the end of the operation. An additional 91 patients were included as controls. RESULTS There were no significant differences between the study groups in terms of intraoperative blood loss, which was 500 mL for both groups (p>0.999). Also, intraoperative blood transfusion requirements were similar between both groups (p=0.330). Mean blood transfusion amounts were 125±35 mL for patients in the TXA group and 85±25 mL in the control group. However, there was a significant reduction in postoperative blood transfusion (p=0.003) in the TXA group. Only three cases in the TXA group required blood transfusion, while 15 cases in the control group did. CONCLUSION We confirmed that low dose TXA has no effect on intraoperative blood loss volume or blood transfusion requirements and that it can significantly reduce the need for postoperative blood transfusions.
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Affiliation(s)
- Mahmoud Abdou
- Department of Orthopedic Surgery, Fayoum University College of Medicine, Fayoum, Egypt
| | - Ji-Won Kwon
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Jin Kim
- Department of Anesthesia, Yonsei University College of Medicine, Seoul, Korea
| | - Bora Lee
- Department of Anesthesia, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Seon Choi
- Department of Anesthesia, Yonsei University College of Medicine, Seoul, Korea
| | - Seong-Hwan Moon
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Byung Ho Lee
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
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Rodríguez-García FA, Sánchez-Peña MA, de Andrea GT, Villarreal-Salgado JL, Álvarez-Trejo HJ, Medina-Quintana VM, García-Valenzuela SE, Morfin-Meza KE, Fierro-Rodríguez DA, Dorado-Hernández E, Bonilla-Catalán PV, Ramos-Maciel J, Romero-Algara E, Jiménez-Pavón KE, Torres-Salazar QL. Efficacy and Safety of Tranexamic Acid for the Control of Surgical Bleeding in Patients Under Liposuction. Aesthetic Plast Surg 2022; 46:258-264. [PMID: 34351508 DOI: 10.1007/s00266-021-02486-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/18/2021] [Indexed: 11/27/2022]
Abstract
Liposuction remains one of the most frequently performed cosmetic surgical procedures and its popularity is increasing every year. However, since its inception, justified concerns regarding patient safety have placed limits on the volume of fat that can be aspirated, influenced by hemodynamic fluctuations and blood loss during liposuction. Tranexamic acid (TXA) is an antifibrinolytic agent that competitively inhibits the conversion of plasminogen to plasmin, thus preventing the binding and degradation of fibrin. Despite the existence of evidence of the effectiveness of TXA in orthopedic and cardiac surgeries, there is little evidence of its use in liposuction. The objective of this study was to evaluate the efficacy and safety of tranexamic acid in the control of surgical bleeding in patients undergoing liposuction, through a prospective, open, randomized and controlled clinical trial. Two groups of 25 participants each were formed to whom the application of TXA in a tumescent solution prior to liposuction or liposuction with the traditional technique was randomly assigned. The results showed a decrease in blood loss reflected by the differences in the final hematocrit values, as well as decrease in the same per aspirated volume (p = 0.003). No adverse events were found related with the TXA application and no blood transfusions were required in this group, in contrast to the control group where the need for blood transfusion was present in 20% of the intervened participants. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- F A Rodríguez-García
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional "Dr. Valentín Gómez Farias", Av. Soledad Orozco 203, El Capullo, 45100, Zapopan, Guadalajara, Jalisco, México
| | - M A Sánchez-Peña
- Hospital INNOVARE, Av. Verona 7412, Villa Verona, Zapopan, Jalisco, México
| | | | - J L Villarreal-Salgado
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional "Dr. Valentín Gómez Farias", Av. Soledad Orozco 203, El Capullo, 45100, Zapopan, Guadalajara, Jalisco, México
| | - H J Álvarez-Trejo
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional "Dr. Valentín Gómez Farias", Av. Soledad Orozco 203, El Capullo, 45100, Zapopan, Guadalajara, Jalisco, México
| | - V M Medina-Quintana
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional "Dr. Valentín Gómez Farias", Av. Soledad Orozco 203, El Capullo, 45100, Zapopan, Guadalajara, Jalisco, México
| | - S E García-Valenzuela
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional "Dr. Valentín Gómez Farias", Av. Soledad Orozco 203, El Capullo, 45100, Zapopan, Guadalajara, Jalisco, México
| | - K E Morfin-Meza
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional "Dr. Valentín Gómez Farias", Av. Soledad Orozco 203, El Capullo, 45100, Zapopan, Guadalajara, Jalisco, México
| | - D A Fierro-Rodríguez
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional "Dr. Valentín Gómez Farias", Av. Soledad Orozco 203, El Capullo, 45100, Zapopan, Guadalajara, Jalisco, México
| | - E Dorado-Hernández
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional "Dr. Valentín Gómez Farias", Av. Soledad Orozco 203, El Capullo, 45100, Zapopan, Guadalajara, Jalisco, México
| | - P V Bonilla-Catalán
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional "Dr. Valentín Gómez Farias", Av. Soledad Orozco 203, El Capullo, 45100, Zapopan, Guadalajara, Jalisco, México
| | - J Ramos-Maciel
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional "Dr. Valentín Gómez Farias", Av. Soledad Orozco 203, El Capullo, 45100, Zapopan, Guadalajara, Jalisco, México
| | - E Romero-Algara
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional "Dr. Valentín Gómez Farias", Av. Soledad Orozco 203, El Capullo, 45100, Zapopan, Guadalajara, Jalisco, México
| | - K E Jiménez-Pavón
- Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional "Dr. Valentín Gómez Farias", Av. Soledad Orozco 203, El Capullo, 45100, Zapopan, Guadalajara, Jalisco, México
| | - Q L Torres-Salazar
- Universidad Juárez del Estado de Durango, Calle Paloma No.806, Colonia Fátima, 34060, Durango, Durango, México.
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