Abstract
BackgroundTo indicate whether combined topical and intravenous (IV) administration of tranexamic acid (TXA) could further reduce the blood loss after surgery for adolescent idiopathic scoliosis (AIS) compared with IV-TXA alone.MethodsNinety AIS patients who underwent posterior spinal fusion were prospectively randomized to combined group (IV + topical- TXA group) and IV-TXA alone group. TXA was infused at a loading dose of 1 g from the beginning of the surgery with a maintenance dose of 10 mg/kg/h until the wound was closed. In the combined group, 2 g TXA was injected retrogradely through a drain, while an equivalent amount of normal saline was injected in the IV-TXA alone group. The drain tube was clamped for 2 h in both groups. The amount of wound drainage and transfusion rates were analyzed.ResultsThe drainage volume and duration of drain were significantly lower in the combined group compared with that in the IV-TXA alone group (372.0 ± 129.7 mL vs. 545.2 ± 207.7 mL, P < 0.001;64.7 ± 13.9 h vs. 82.0 ± 12.5 h, P < 0.001). Postoperative length of hospital stay was also significantly shorter in the combined group (6.5 ± 1.51 days vs. 7.95 ± 1.44 days, P < 0.05). Transfusion and complication rates were comparable between the two groups .ConclusionsIV injection of TXA combined with retrograde injection of TXA into a drain and clamping it for 2 h could further reduce the total volume of drainage in AIS patients who underwent spinal fusion surgery.Trial registrationChinese Clinical Trial Registry: ChiCTR1900024177, Registered 29 June 2019, http://www.chictr.org.cn/showproj.aspx?proj=40214
Highlights
To indicate whether combined topical and intravenous (IV) administration of tranexamic acid (TXA) could further reduce the blood loss after surgery for adolescent idiopathic scoliosis (AIS) compared with IV-TXA alone
Decortication of bone surface further increases the blood loss and the postoperative volume of drainage [1].As the risk of allogeneic blood transfusion (ABT)transmitted viruses was reduced to quite low levels in the United States, transfusion-related acute lung injury (TRALI), hemolytic transfusion reactions (HTRs), and transfusion-associated sepsis (TAS) emerged as the leading causes of ABT-related deaths [2]
The author assessed local application of TXA by injecting it through drain tube. They concluded that topical application of TXA via a wound drain tube and clamping it for 1 h could effectively decrease the postoperative blood loss and the hospital stay in degenerative scoliosis surgeries [10]
Summary
To indicate whether combined topical and intravenous (IV) administration of tranexamic acid (TXA) could further reduce the blood loss after surgery for adolescent idiopathic scoliosis (AIS) compared with IV-TXA alone. The author assessed local application of TXA by injecting it through drain tube They concluded that topical application of TXA via a wound drain tube and clamping it for 1 h could effectively decrease the postoperative blood loss and the hospital stay in degenerative scoliosis surgeries [10]. In the present study, aimed to indicate whether combined intravenous (IV) and topical injection of TXA via a drain tube and clamping it for 2 h could further reduce the postoperative blood loss in adolescent idiopathic scoliosis (AIS) cases who underwent spinal fusion surgery
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