Efficacy and safety of multiple intravenous application of tranexamic acid for reducing perioperative bleeding during total hip arthroplasty：a prospective randomized controlled trial
YAO Huan
XIE Jin-wei
YUE Chen
MA Jun
PEI Fu-xing
Abstract：Objective To explore the efficacy and safety of multiple intravenous application of tranexamic acid ( TXA ) in reducing perioperative blood loss in primary unilateral total hip arthroplasty ( THA ). Methods A total of 90 patients undergoing THA between December 2014 and September 2015 were divided into 3 groups randomly. Single dose group: 20 mg / kg TXA was intravenously given before the operation in 30 patients. Double dose group:30 patients received 20 mg / kg TXA before the operation and 10 mg / kg TXA again 3 hours later. Triple dose group:TXA was given at a dose of 20 mg / kg before the operation and twice thereafter, at 3-hour intervals. All patients were given a total of 1.5 g TXA during the operation at 3 time points. Hidden blood loss, the maximum hemoglobin ( Hb ) drop, total blood loss, transfusion, embolism events, postoperative draining, length of stay and other complications were recorded. Results In the triple group, hidden blood loss was ( 308.21 ± 221.91 ) ml, the maximum Hb drop was ( 20.07 ± 6.06 ) g / L, total blood loss was ( 589.34 ± 190.85 ) ml, which were significantly lower than those in the other 2 groups. Total blood loss ( 815.57 ± 234.31 ) ml and postoperative draining ( 180.67 ± 77.68 ) ml of double dose group were also significantly lower than those of single dose group. No patients needed transfusion in any of the 3 groups. Pulmonary embolism and deep vein thrombosis ( DVT ) were not observed in any group. Conclusions Intravenous application of tranexamic acid is effective in reducing hidden blood loss and hemoglobin loss without increasing the risk of embolic events. Meanwhile, triple dose intravenous application of TXA is better than single and double dose intravenous application.
Keywords：Tranexamic acidArthroplastyreplacementhipBlood losssurgicalHip joint
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 885-890 )