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Tranexamic Acid and Intraoperative and Postoperative Accumulative Bleeding in Elective Degenerative Spine Surgery

 Mahmoud Abdou  ;  Ji-Won Kwon  ;  Hye Jin Kim  ;  Bora Lee  ;  Yong Seon Choi  ;  Seong-Hwan Moon  ;  Byung Ho Lee 
 YONSEI MEDICAL JOURNAL, Vol.63(10) : 927-932, 2022-10 
Journal Title
Issue Date
Antifibrinolytic Agents* / therapeutic use ; Blood Loss, Surgical / prevention & control ; Blood Transfusion ; Elective Surgical Procedures ; Humans ; Tranexamic Acid* / therapeutic use
Blood loss ; PLIF ; blood transfusion ; intraoperative ; postoperative ; tranexamic acid
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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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Ji-Won(권지원) ORCID logo https://orcid.org/0000-0003-4880-5310
Kim, Hye Jin(김혜진) ORCID logo https://orcid.org/0000-0003-3452-477X
Moon, Seong Hwan(문성환)
Lee, Byung Ho(이병호) ORCID logo https://orcid.org/0000-0001-7235-4981
Lee, Bo Ra(이보라) ORCID logo https://orcid.org/0000-0002-7699-967X
Choi, Yong Seon(최용선) ORCID logo https://orcid.org/0000-0002-5348-864X
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