A prospective study to assess the efficacy of tranexamic acid in reducing blood loss during total hip arthroplasty

Background: Tranexamic acid has been reported to reduce bleeding, risk of thromboembolic events and the need for allogenic blood transfusion in total hip replacement patients. The present study was conducted to assess the efficacy of tranexamic acid in reducing blood loss during total hip replacement surgery.Methods: Total hip arthroplasty patients (n=60) were divided into control and test groups with 30 patients each. Test group was administered with tranexamic acid (15 mg/kg) for 15 min before and after the surgery. Patients were administered cefuroxime (1.5 g), 30 min prior to the surgery and deep vein thrombosis prophylaxis; enoxaparin (40 mg), 48 hours after surgery. Demographic details along with levels of hemoglobin and blood loss before, during and after the surgery were recorded.Results: Tranexamic acid reduced the early post-surgical blood loss (292±132.38 vs. 155.8±86.56 ml; p<0.0001), total blood loss (989.6±340.98 vs. 580.4±131.88 ml; p<0.0001), and the blood loss during surgery (723.5±277.73 vs. 434.3±131.83 ml; p<0.05). Test group required fewer transfusions (6.7%) than control group (26%) and had no increased incidence of deep-vein thrombosis. Postsurgical hemoglobin in the control group had significantly reduced as compared to test group.Conclusions: Administration of intravenous tranexamic acid before and after the surgery was effective in reducing the blood loss and transfusion requirements and its related complications