O uso do ácido tranexâmico em pacientes submetidos a artroplastia total primária do quadril: uma avaliação do seu impacto em diferentes protocolos de administração

Abstract

ObjectivesThere is still no consensus as to the best form and dosages of use of Tranexamic Acid (TXA). The aim of this study was to evaluate the use of TXA in total hip arthroplasty (THA), in order to reduce blood loss and decrease hemoglobin, taking into account different administration protocols. Methods42 patients submitted to THA were divided into three groups. The study was prospective and randomized. Group 1 received a venous dose of TXA of 15mg/kg 20minutes prior to bolus incision. Group 2 received an intravenous dose of 15mg/kg bolus, 20minutes before the incision, and an extra dose of 10mg/kg by infusion pump during the duration of the surgical procedure. Patients in Group 3 did not receive TXA, being the control group. Pre‐ and post‐operative hemoglobin levels were measured and blood loss was measured 24hours after surgery using a Portovac drain. ResultsThere was a significant reduction in the amount of bleeding through the Portovac drain and reduction in postoperative hemoglobin drop in patients who used TXA. There was no significant difference in hemoglobin drop between groups 1 and 2, nor was there a need for hemotransfusion. Two patients in group 3 required blood transfusion. ConclusionsThe findings demonstrated that the use of intravenous tranexamic acid in THA reduced postoperative bleeding rates and significantly reduced serum hemoglobin without increasing thromboembolic effects. The bolus and bolus+infusion pump methods were shown to have a similar influence on hemoglobin and need for blood transfusion.