Anti-inflammatory effect of tranexamic acid in the perioperative period of total knee arthroplasty
10.3760/cma.j.issn.1008-6706.2021.03.018
- VernacularTitle:氨甲环酸在全膝关节置换术围手术期的抗炎效果研究
- Author:
Silong LIN
;
Hong PAN
- From:
Chinese Journal of Primary Medicine and Pharmacy
2021;28(3):400-404
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the anti-inflammatory effect and safety of tranexamic acid in the perioperative period of total knee arthroplasty.Methods:Eighty patients who underwent primary unilateral total knee arthroplasty because of knee osteoarthritis in Anqing Hospital of Anhui Medical University from October 2018 to March 2020 were included in this study. They were divided into an observation group and a control group ( n = 40/group) according to whether they received tranexamic acid treatment. In the observation group, 1 g tranexamic acid was intravenously administered at 10 minutes before releasing tourniquet and once every 3 hours starting at 24 hours after surgery. In the control group, 100 mL 0.9% sodium chloride injection was identically administered. Before surgery, immediately after surgery, and 1, 2 and 3 days after surgery, interleukin-6 level, erythrocyte sedimentation rate and C-reactive protein level in the venous blood were compared between the observation and control groups. Coagulation function and lower extremity deep venous thrombosis in the two groups were monitored. Postoperative pain, nausea, vomiting and muscle strength were compared between the two groups. Results:There were no significant differences in age, gender, body mass index and Hospital for Special Surgery knee score between the two groups (all P > 0.05). Univariate analysis of variance revealed that there were significant differences in interleukin-6 level ( t1 = 9.364, t2 = 11.027, t3 = 11.068), erythrocyte sedimentation rate ( t1 = 20.94, t2 = 18.898, t3 = 22.797) and C-reactive protein level ( t1 = 14.079, t2 = 12.099, t3 = 23.416) between the two groups at 1, 2 and 3 days after surgery (all P < 0.05). Regression analysis revealed that the maximum differences in erythrocyte sedimentation rate ( β = 0.217, P = 0.038), interleukin-6 ( β = 0.143, P = 0.025) and C-reactive protein ( β = 0.032, P = 0.010) between before and after total knee arthroplasty in the observation group were significantly lower compared with the control group ( β > 0, P < 0.10). Moreover, the differences in erythrocyte sedimentation rate, interleukin-6 and C-reactive protein at 3 days after surgery were significantly lower compared with at the other time points studied. Before and after surgery, there was no significant difference in coagulation function between the two groups (both P > 0.05). Lower extremity deep venous thrombosis occurred in neither groups. The recovery of postoperative pain, nausea, vomiting, and muscle strength in the observation group was significantly superior to that in the control group (all P < 0.05). Conclusion:Application of tranexamic acid in primary unilateral total knee arthroplasty can effectively attenuate perioperative inflammatory reaction, reduce postoperative adverse reactions and promote functional recovery, which deserves clinical application.
