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KMID : 0361620140490030195
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Journal of the Korean Orthopaedic Association
2014 Volume.49 No. 3 p.195 ~ p.201
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Effectiveness of Tranexamic Acid in Reducing Blood Loss after Spinal Fusion
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Kim Young-Tae
Cho Kyu-Jung
Kim Geon-Ho
Choi Jae-Hwang
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Abstract
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Purpose: Spinal fusion surgery can be associated with significant blood loss, often requiring blood transfusion. The objective of this retrospective study was to evaluate the efficacy of tranexamic acid in reducing blood loss and transfusion after lumbar spinal fusion.
Materials and Methods: A total of 75 consecutive patients undergoing spinal fusion surgery for spinal stenosis were included in this study. Thirty-five patients who were administered tranexamic acid were compared with 40 patients who did not receive the drug. Blood loss through drain, amount of blood transfusion, and hematological laboratory findings were evaluated.
Results: Blood loss through drain for the first 24 hours after surgery was 548.6±192.1 ml in the tranexamic acid group and 1,089.8±368.3 ml in the control group with a significant difference (p=0.001). Total blood loss through drain was 1,010.5±452.5 ml in the tranexamic acid group and 1,512.7±427.8 ml in the control group with a significant difference (p=0.005). Time to removal of drains after surgery was not different, 2.6±0.8 days in the tranexamic acid group and 2.5±1.1 days in the control group (p=0.885). Packed red blood cell (RBC) transfusion for the postoperative period and the number of patients requiring transfusion was significantly lower in the tranexamic acid group than in the control group. A prolongation of protrombin time was observed in the control group on first postoperative day. There were no complications related to the use of tranexamic acid.
Conclusion: Tranexamic acid had an effect on reducing blood loss through drain for the first 24 hours and total blood loss after spinal fusion surgery. As a result, there was less of a requirement for RBC transfusion after surgery.
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KEYWORD
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tranexamic acid, spinal fusion, hemorrhage, drainage, blood transfusion
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