Highlights
- •Multiple boluses of oral TXA and intravenous TXA postoperatively are equivalent in reducing blood loss, Hb and Hct drop in primary THA.
- •Both multiple boluses of oral TXA and intravenous TXA are safe without increasing the risk of thromboembolic diseases and wound complications in primary THA.
- •Oral TXA is superior considering cost-efficient benefits compared with the intravenous formulation.
Abstract
Background
The purpose of this study was to determine whether the administration of multiple
boluses of oral and intravenous tranexamic acid (TXA) postoperatively was equivalent
in reducing blood loss in primary THA.
Methods
A total of 108 patients were randomized into two groups: oral TXA group (54 patients
receiving 1 dose of 20 mg/kg intravenous TXA 5–10 min before skin incision and 3 doses
of 2 g oral TXA 4 h, 10 h and 16 h postoperatively) and intravenous TXA group (54
patients receiving 1 dose of 20 mg/kg intravenous TXA 5–10 min before skin incision
and 3 doses of 1 g intravenous TXA 6 h, 12 h and 18 h postoperatively). The primary
outcomes were total blood loss, hidden blood loss, length of hospital stay, hemoglobin
(Hb) and hematocrit (Hct) drop. The secondary outcomes were the level of inflammation
markers and complications.
Results
There was no difference in the mean total blood loss or hidden blood loss [728.4 (645.8–806.9)
mL vs 703.6 (576.9–832.8) mL, p = 0.745; 634.6 (552.0–715.7) mL vs 606.4 (480.1–734.5) mL, p = 0.710] and length of hospital stay was similar between the two groups. No patients
received allogenic blood transfusion. The Hb and Hct drop on the first and second
postoperative days were similar (p > 0.05). The level of inflammation markers did not reach statistical significance.
The incidence of complications did not differ significantly between the two groups.
Conclusions
Multiple boluses of oral TXA and intravenous TXA postoperatively are equivalent in
reducing blood loss, Hb and Hct drop in primary THA without increasing the risk of
thromboembolic diseases and wound complications.
Keywords
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Article info
Publication history
Published online: February 15, 2018
Accepted:
February 13,
2018
Received in revised form:
February 6,
2018
Received:
November 29,
2017
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
