Results after the application of tranexamic acid intravenous or intra-articular in the control of postsurgical bleeding after total hip arthroplasty: a randomized controlled trial
Por:
Gómez-Aparicio MDS, Gómez-Barbero P, Blas-Dobón JA, Villar-Blanco A, Morales-Suárez-Varela M and Rodrigo-Pérez JL
Publicada:
1 oct 2020
Ahead of Print:
5 may 2020
Resumen:
IntroductionA frequent complication after total hip arthroplasty is bleeding; to reduce it, intravenous or intra-articular tranexamic acid (TXA) is used. There is no evidence yet on which route of administration is better. Materials and methodThis was a prospective, controlled, randomized study in 2 arms between February 2017 and February 2019. In group A, 15 mg/kg intravenous TXA was administered and in group B 2 g intra-articular TXA. Haemoglobin and haematocrit values were evaluated at 24-72 h, also volume of drained blood, volume of blood lost, transfusions and complications. ResultsA total of 195 patients were included: 110 in group A and 85 group B. Haemoglobin dropped 3.101.32 g/dl in 24 h and 3.631.41 g/dl at 72 h in group A; the haematocrit dropped 8.38 +/- 4.67% in 24 h and 15.40 +/- 4.39% in 72 h. In group B, haemoglobin dropped 3.09 +/- 1.40 g/dl in 24 h and 3.34 +/- 1.23 g/dl in 72 h and haematocrit 9.75 +/- 3.95% and 10.40 +/- 3.72% in 24 and 72 h. No significant differences were found for haemoglobin values at 24 and 72 h and haematocrit at 24 h (p>0.05); we did not obtain statistically significant differences in drainage, blood loss between groups or in the proportion of transfused. When stratifying the results by age, we obtained significant differences in the decrease in haemoglobin (p=0.021) and haematocrit (p=0.025) in patients>65 years.ConclusionsThe different routes of administration of TXA in PTC have a similar effect in reducing post-operative bleeding without evidencing an increase in complications.Level of evidenceI.
Filiaciones:
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Department of Orthopedic Surgery and Traumatology, Doctor Peset University Hospital, Avenida Gaspar Aguilar, 90, 46017, Valencia, Spain.
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Department of Orthopedic Surgery and Traumatology, Doctor Peset University Hospital, Avenida Gaspar Aguilar, 90, 46017, Valencia, Spain
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Department of Orthopedic Surgery and Traumatology, Doctor Peset University Hospital, Avenida Gaspar Aguilar, 90, 46017, Valencia, Spain
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Department of Orthopedic Surgery and Traumatology, Doctor Peset University Hospital, Avenida Gaspar Aguilar, 90, 46017, Valencia, Spain
Morales-Suárez-Varela M:
Unit of Preventive Medicine and Public Health, Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Department of Orthopedic Surgery and Traumatology, Doctor Peset University Hospital, Avenida Gaspar Aguilar, 90, 46017, Valencia, Spain
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