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EFFECTS OF TRANEXAMIC ACID IN TOTAL HIP ARTHROPLASTY.



Abstract

Introduction: Numerous studies have been carried out to assess the efficacy of tranexamic acid on intra and post operative blood loss and its implications. Many of these studies conclude that there is a need to study the effects of tranexamic acid on actual post Operative blood transfusion, thromboembolic events and hospital stay.

We analyzed the effects of Tranexamic acid on Intra- operative blood loss, post Operative haemoglobin and haematocrit drop, blood transfusion requirement, incidence of deep vein thrombosis and hospital stay in Patients undergoing Total hip arthroplasty.

Methods: Prospective case control study involving 50 patients (25 in each category, ASA class I to III) operated by a single consultant. Patient were given single dose of Intra venous Tranexamic Acid (10 mg/kg,10 minutes pre-incision) and Intra operative blood loss was compared to control group analyzing dry and wet swab weights and irrigation fluid. The actual haemoglobin drop, blood transfusion requirement, average length of stay in hospital and incidence of DVT were noted.

Results: There was 30% reduction in intra operative blood loss in the study group. None of the other parameters show evidence of a statistically significant difference between the groups. The average hospital stay was 7 days in both the groups.

Discussion: We found out that Tranexamic acid makes little difference in terms of actual haemoglobin and haematocrit drop, blood transfusion requirement and hospital stay. Our study didn’t show any rise in deep vein thrombosis in treatment group. The only difference it made was reduction of intraoperative blood loss by 30%. To the best of our knowledge, ours is the only study which combines all these parameters.

Correspondence should be addressed to BHS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.