EFFECT OF TRANEXAMIC ACID IN REDUCING BLOOD LOSS DURING THORACOLUMBAR SPINE SURGERY

Abstract

BACKGROUND: Spine surgeries are usually associated with excessive blood loss, which increases morbidity and mortality due to hemodynamic instability and subsequent blood transfusions. Tranexamic acid (TXA), an antibrinolytic drug, inhibits the activation of plasminogen, is found to be useful in reducing blood loss. METHODOLOGY: A prospective observational study conducted in Government Medical College, Kottayam for a period of twelve months, randomly assigned forty-eight adult patients (ASA I or II) undergoing thoracolumbar spine surgery into two groups, who received either a bolus of 10 mg/kg IV TXA after induction followed by an infusion of 1 mg/kg/h of TXA up to closure of skin, or an equivalent volume of normal saline. Blood investigations, surgical parameters, perioperative blood loss and blood transfusions were assessed. RESULTS: Both groups in the study were comparable with respect to demographic variables, baseline laboratory indices and surgical parameters. The mean perioperative blood loss was 44% less (P<0.05) and blood transfusion requirements were 71% reduced (P<0.05) in patients who received TXA. Mean surgical duration as well as postoperative hemoglobin drop was signicantly reduced in TXA group compared to Normal Saline group (NS). CONCLUSION: Tranexamic acid reduces perioperative blood loss and blood transfusion.