In this prospective, randomized, double-blind study, we have investigated the effect of an antifibrinolytic agent tranexamic acid (cyclokapron), on blood loss, transfusion requirements and blood coagulation associated with total knee arthroplasty in fourty ASA I/II patients. Tranexarnic acid 15mg/ kg-1 (n=20) or an equivalent volume of normal saline (n=20) was given 30 min before surgery and subsequently every 8k for 3 days. Coagulation and fibrinolysis values were measured before administration of tranexamic acid (pm-operative). 8k after the end of surgery coagu/ation, ftbrinolysis, blood loss are measured and then 24h, 48h and 72h later. The amount of blood transfused was measured in the two groups. Total blood loss in tranexcunic acid group was (665 (348) ml compared with 1406 (616) ml in placebo group (p<0.001), and occurred primarily during the first 24h after surgery. Twelve patients received 1-5 units of packed red blood cells in placebo group compared with two patients in tranexamic acid group, who received 3 units (p<0.001). Post-operative packed cell volume values were higher in the tranexamic acid group despite fewer blood transfusion. Platelet count, FT, aFTT, bleeding time and fibrinogen didn't differ between groups. We conch uiPd that tranexamic acid reduced postoperative blood loss and transfusion requirements associated with total knee arthroplasty |
