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document
Reducing blood loss in simultaneous bilateral total knee arthroplasty : combined intravenous-intra-articular tranexamic acid administration . A prospective randomized controlled trial . BACKGROUND We asked whether tranexamic acid ( TXA ) administration could reduce blood loss and blood transfusion requirements after simultaneous bilateral total knee arthroplasty ( TKA ) . This study examined the role of a novel method of TXA administration in TKA . METHODS TXA was administered as a bolus dose of 15 mg/kg 10 min before the inflation of the tourniquet on the first side . This was followed by intra-articular administration of 3 grams at 10 min before the deflation of the tourniquet . IV infusion of 10 mg/kg/h was continued for 3h following completion on the second side . We measured volume of drained blood 48 h postoperatively , decrease in hemoglobin levels 12h postoperatively , amount of blood transfused ( BT ) , and number of patients requiring allogenic BT . RESULTS Median postoperative volume of drained blood was lower in the group receiving TXA ( 500.00 mL ) than in control subjects ( 900.00 mL ) ( p < 0.05 ) [ 95 % CI ( -525.00 ) to ( -300.00 ) ] . The median hemoglobin decrease 12 h postoperatively was lower in patients receiving TXA ( 2.10 g/dL ) than in control subjects ( 3.10 g/dL ) ( p < 0.05 ) [ 95 % CI ( -1.60 ) to ( -0.60 ) ] . The amount of BT and number of patients requiring BT were lower in patients receiving TXA than in control subjects . Nevertheless , the number of allogeneic units of packed red blood cells transfused in the postoperative period was not significantly higher in the control group than in the TXA group ( p=0.109 ) [ 95 % CI ( 0.101 ) to ( 0.117 ) ] . CONCLUSIONS This prospective randomized study showed that during simultaneous bilateral TKA , TXA reduced blood loss with negligible side effects .
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Intervention_Pharmacological
tranexamic acid
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Intervention_Pharmacological
tranexamic acid ( TXA )
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Intervention_Pharmacological
TXA was administered as a bolus dose
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Intervention_Pharmacological
intra-articular administration
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Intervention_Pharmacological
IV infusion
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Intervention_Pharmacological
TXA
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Intervention_Pharmacological
TXA
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Outcome_Physical
blood loss
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Outcome_Physical
blood loss and blood transfusion requirements
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Outcome_Physical
volume of drained blood 48 h postoperatively , decrease in hemoglobin levels 12h postoperatively , amount of blood transfused ( BT )
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Outcome_Physical
number of patients requiring allogenic BT .
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Outcome_Physical
volume of drained blood
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Outcome_Physical
median hemoglobin decrease 12 h postoperatively
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Outcome_Other
amount of BT and number of patients requiring BT
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Outcome_Physical
packed red blood cells transfused
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Outcome_Physical
blood loss
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Outcome_Adverse-effects
side effects .
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Participant_Condition
simultaneous bilateral total knee arthroplasty
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Participant_Condition
simultaneous bilateral total knee arthroplasty ( TKA )