Intravenous versus topical tranexamic acid as a blood conservation intervention in hip joint replacement surgeries

Abstract

Background: Hip arthroplasty is associated with substantial blood loss intraoperatively as well as postoperatively. The objective of the present experimental study was to compare the effectiveness of topical tranexamic acid with intravenous tranexamic acid in reducing blood loss in hip joint replacement surgeries. Methods: The experimental study comprised of 60 cases undergoing hip joint replacement surgeries who were randomly assigned to the intravenous group (n=30) and topical group (n=30). Tranexamic acid was used in the dose of 15 mg/kg. All Patients undergoing hip joint replacement surgeries and preoperative Hb > 10 g/dl for males and > 9 g/dl for females were included in this study. Patients having a known history of thromboembolic disease, myocardial infarction, cerebrovascular disease, angina, coagulopathy, any liver or renal disease or any other source of active bleeding were excluded from the study. Results: In hemiarthroplasty the blood loss in the topical and intravenous group was 547.8±178.11ml and 617.73±192.51ml with a p value of 0.298. The haemoglobin and PCV was 2.01±1.18 mg/dl, 6.22±4.08% and 2.41±1.74 mg/dl, 6.69±5.03 with a p value of 0.521 and 0.865. Similarly in total hip replacement the blood loss in the topical and intravenous group was 620.80±160.33ml and 745.30±152.67ml with a significant p value of 0.046. The haemoglobin and PCV was 2.75±1.60 mg/dl, 6.15±7.05% and 2.80±1.84 mg/dl, 8.52±5.47 with a p value of 0.534 and 0.214. Conclusion: Tranexamic acid can be given by intravenous or topical route as both the routes are equally effective in reducing the intraoperative blood loss.