Efficacy of Intravenous Tranexamic Acid on Perioperative Blood Loss and Transfusion Requirement in Spine Fusion Surgery

Abstract

Introduction: Blood loss associated with spine fusion surgery is a common potential cause of morbidity and often requires a blood transfusion, which subjects patients to risks of blood transfusion. Tranexamic acid is used intra-operatively to reduce bleeding in major surgeries. This study aims to evaluate its efficacy on perioperative blood loss and transfusion requirement in patients undergoing spine fusion surgery
 Methods: This prospective randomised controlled study was conducted at Department of Orthopedics of Tribhuvan University Teaching Hospital between August 2015 and July 2016. Patients undergoing spine fusion surgery were randomly assigned to group A (TXA) and group B (control) equally, thirty patients in each group. TXA was given to group A in a loading dose of 10 mg/kg, followed by continuous infusion of 1 mg/kg/hr during surgery. Outcome measures included perioperative blood loss, amount of blood transfusion, and safety and adverse effects. The data were analyzed by means of SPSS version 21.0. The results were presented as mean ± SD. Differences were considered significant if the P-value was <0.05.
 Results: Sixty patients (31 males, 29 females) with mean age of 39.95 years were enrolled in study, thirty patients in each group. Statistical analysis showed no significant differences between the 2 study groups with regard to age, sex, weight, preoperative hemoglobin, level of fusion as well as operative time. The amount of perioperative blood loss was significantly less in the group A versus group B, 241.274±162.819 ml vs 661.053±189.469 ml, p=0.000. There was no difference in the incidence of allogenic blood transfusion. There were no complications related to use of TXA in this study.
 Conclusion: TXA provided an effective and safe method for reduction of blood loss during and after spine fusion surgery. However, there was no difference in the incidence of perioperative allogeneic blood transfusion.