The effect of tranexamic acid used for spine surgery on blood loss and transfused volume

Yoo, Tae Joong; Jeon, Seung Gyu; Lee, Sangseok; Kim, Kye Min; Yon, Jun Heum; Hong, Ki Hyuk

Clinical Research

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2009;4(2):106-112.
Published online April 30, 2009.

The effect of tranexamic acid used for spine surgery on blood loss and transfused volume

Tae Joong Yoo, Seung Gyu Jeon, Sangseok Lee, Kye Min Kim, Jun Heum Yon, Ki Hyuk Hong

Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea. siestalee@gmail.com

Abstract

BACKGROUND
In this randomized controlled study, we evaluate the effect of tranexamic acid on perioperative blood loss and transfused volume in patients undergoing spine surgery.
METHODS
We enrolled and randomly allocated 40 patients scheduled for spine surgery under general anesthesia to either tranexamic group or control group. Tranexamic acid was given to tranexamic group with loading dose 10 mg/kg for 15 minutes followed by continuous infusion at the rate of 1 mg/kg/h. In control group, equivalent volume of normal saline was given with the same manner and rate, until the end of procedure. We examined the total blood loss and transfused volume perioperatively. Also we evaluated hemoglobin, platelet, prothrombin time, partial thromboplastin time and thromboelastography before and after surgery.
RESULTS
The groups did not differ significantly. Intraoperative blood loss was 1,130.0 +/-563.9 (mean +/-SD) ml in control group and 1,061.5 +/-509.7 ml in tranexamic group. Blood loss at postoperative 12 h and 24 h were 392.0 +/-222.0 ml, 466.0 +/-323.2 ml in control group and 158.5 +/-100.6 ml, 470.2 +/-232.7 ml in tranexamic group respectively. Transfused volumes at intraoperative and postoperative period were differing significantly (1,300.0 +/-709.3 ml, 800.0 +/-343.3 ml in control group compared to 1,020.0 +/-476.3 ml, 340.0 +/-325.0 ml in tranexamic group).
CONCLUSIONS
Loading dose of 10 mg/kg tranexamic acid and followed infusion at 1 mg/kg/h reduce perioperative blood transfused volume during spinal surgery.

Key Words: antifibrinolytic agents, spinal fusion, tranexamic acid