Background and aim: The study aim was to compare whether high dose or low dose
tranexamic acid have an effect in decreasing perioperative blood loss in spine surgery case
and determine whether the expected reduction in the bleeding was capable of reducing the
need for blood transfusion.
Patients and methods: This study was prospective, double blind, RCT study in which
sixty patients were scheduled for posterior arthrodesis of spinal cord with fusion of one or
two levels under general anesthesia. The patients were randomly allocated into three equal
groups. Group C (control) received normal saline, group HD (high does) received 50 mg/
kg of tranexamic acid administered over 30 min before skin incision and continued at the
rate of 20 mg/kg/h until the end of the procedure and group LD (low does) received 10 mg/
kg of tranexamic acid over 30 min before skin incision and continued at the rate of 1 mg/
kg/h until the end of the procedure. The total amount of blood loss intraoperative and in
the first 24 hours postoperative and hemoglobin concentration (preoperative and one day
postoperative) were recorded.
Results: HD group and LD group showed a highly significant decrease in blood loss in
comparison with the control group (p