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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(01): 51-55
DOI: 10.4103/ajns.AJNS_339_20
Original Article

Castigating intraoperative bleeding: Tranexamic acid, a new ally

Krashan Hanada
1   Department of Anesthesia, King Hussein Medical Center, Royal Medical Services, Amman
,
Alhasan Ahmad
1   Department of Anesthesia, King Hussein Medical Center, Royal Medical Services, Amman
,
Hammadeen Shadi
1   Department of Anesthesia, King Hussein Medical Center, Royal Medical Services, Amman
,
Alnajada Wajdi
2   Department of Radiation Oncology, Queen Alia Military Hospital, Royal Medical Services, Amman
,
Saraireh Haitham
2   Department of Radiation Oncology, Queen Alia Military Hospital, Royal Medical Services, Amman
,
Khresat Wesam
1   Department of Anesthesia, King Hussein Medical Center, Royal Medical Services, Amman
,
Arabiyat Lamees
3   Department of Plastic Surgery, Farah Medical Center, Royal Medical Services, Amman
,
Malabeh Qamar
4   Department of Radiology, King Hussein Medical Center, Royal Medical Services, Amman
,
Alqroom Rami
5   Department of Neurosurgery, King Hussein Medical Center, Royal Medical Services, Amman
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Introduction: The field of instrumented spinal procedures is associated with substantial blood volume losses, which is one of the major hazards we encounter; this would lead to a greater need for blood products transfusions. The frequent use of these products can have negative consequences due to body fluid shifting, and donor-host rejection. Thus, it has become mandatory to establish strategies to maintain blood volume and minimize losses. Several strategies have been approved to control the disproportionate blood loss. Objective: This study aims to assess the effectiveness of tranexamic acid in reducing intraoperative bleeding during our spine instrumented surgeries, while addressing complications associated. Methods: In this retrospective analysis was steered of 153- consecutive patients treated in the neurosurgical- spine unit of King Hussein hospital, King Hussein Medical Center (KHMC), between April 2017 to January 2020, patients who underwent instrumented surgery for different spinal pathologies at our institute were reviewed. Results: During the analysis period, 153-patients who underwent interbody fusion, were allocated into two groups. The mean instrumented segments were 2.8 level (range 1-5 levels). The demographical data of patients of both groups analyzed. The mean span of operating time was (212.74 ± 41.85 min) for group I, while for the control group mean length was (208.09min ±42.03). Study showed that the mean drop in the hemoglobin concentration postoperatively was statistically significant comparing the two groups. Analysis of blood volume in suction container showed that group I had: 470 ml ±153.06 ml; while in control group volume was: 1560 ml ± 567.59 ml, which showed significant difference (p = 0.002). Comparing the drainage volumes at 12 hours postoperatively displayed no statistically significant differences (p = 0.69) concerning the two groups. Minor adverse effects allied with the tranexamic acid administration. Conclusions: In summary, perioperative bleeding deemed one of the most important threat for patients. Tranexamic acid is proved excellent in controlling perioperative bleeding, harboring few contraindications. Future large studies are still needed to elaborate on unanswered issues.

Key-words:

Antifibrinolytics - fibrinolysis - instrumented spine - intraoperative bleeding - tranexamic acid

Financial support and sponsorship

Nil.




Publication History

Received: 11 July 2020

Accepted: 15 October 2020

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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