Role of Local Infiltration of Tranexamic Acid in Reducing Blood Loss in Peritrochanteric Fracture Surgery in the Elderly Population
- Author:
Virani SR
;
Dahapute AA
;
Panda I
;
Bava SS
- Publication Type:Journal Article
- MeSH:
Tranexamic Acid
- From:Malaysian Orthopaedic Journal
2016;10(3):26-30
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Peritrochanteric fractures are common
injuries occurring in elderly patients. Surgeries for these
fractures are associated with significant blood loss.
Intravenous tranexamic acid has a proven track record in
many orthopaedic surgeries including trauma, arthroplasty
and spine surgeries.
Objective: To study the effect of local subfascial and
intramuscular infiltration of tranexamic acid in reducing
blood loss and the requirement for blood transfusion in
intertrochanteric fracture surgery.
Study Design: Single centre prospective analytical study.
Materials and Methods: One hundred and thirty seven
patients above 65 years of age were included in the study,
divided into two groups: the intervention group received
subfascial and intramuscular infiltration of 2g tranexamic
acid before wound closure and the control group of alternate
patients did not receive any tranexamic acid infiltration. The
postoperative drain output was recorded, as well as the
haemoglobin level and the patients needing blood
transfusion.
Results and Conclusions: The preoperative and
postoperative haemoglobin values were recorded. The mean
preoperative haemoglobin was 10.9% and 10.8% (p=0.79) in
the trial and control groups respectively. The mean
postoperative haemoglobin was 9.5gm% and 9.2gm%
(p=0.36) in the two groups. The total postoperative blood
loss in the tranexamic acid group and the control group was
190.3ml and 204.3ml respectively (p=0.25). Ten patients
(14.9%) in the intervention group and 12 patients (17.1%) in
the control group required blood transfusion. We conclude
that tranexamic acid does not play a significant role in
reducing postoperative blood loss and blood transfusion
when used locally in peritochanteric fracture surgery.
However a larger double blinded study comparing various
modalities of use of tranexamic acid is needed to
conclusively establish its role
- Full text:P020170106550345780519.pdf
