잠시만 기다려 주세요. 로딩중입니다.

Use of Topical Tranexamic Acid to Reduce Blood Loss in Single-Level Transforaminal Lumbar Interbody Fusion

Asian Spine Journal 2020년 14권 5호 p.593 ~ 600
Mallepally Abhinandan Reddy, Mahajan Rajat, Rustagi Tarush, Goel Shakti Amar, Das Kalidutta, Chhabra Harvinder Singh,
소속 상세정보
 ( Mallepally Abhinandan Reddy ) - Indian Spinal Injuries Centre Department of Spine Services
 ( Mahajan Rajat ) - Indian Spinal Injuries Centre Department of Spine Services
 ( Rustagi Tarush ) - Indian Spinal Injuries Centre Department of Spine Services
 ( Goel Shakti Amar ) - Indian Spinal Injuries Centre Department of Spine Services
 ( Das Kalidutta ) - Indian Spinal Injuries Centre Department of Spine Services
 ( Chhabra Harvinder Singh ) - Indian Spinal Injuries Centre Department of Spine Services

Abstract


Study Design: Nonrandomized, prospective, and case-controlled study.

Purpose: To evaluate the efficacy and cost-effectiveness of topically applied tranexamic acid (TXA) during different phases of spine surgery.

Overview of Literature: Perioperative blood loss is the leading cause of postoperative anemia associated with prolonged stays in hospital and long recovery times. The direct and indirect costs involved pose a significant economic challenge in developing countries. There is no consensus for topical use of tranexamic acid in spine surgery.

Methods: Patients requiring a single-level TLIF were divided into two groups. In the TXA group (n=75), the wound surface was soaked with TXA (1 g in 100 mL saline solution) for 3 minutes after exposure, after decompression, and before wound closure, and in the control group (n=175) using only saline. Intraoperative blood loss drain volume was recorded on each of the first 2 days immediately after surgery. An estimated cost analysis was made on the basis of the length of hospital stay and the blood transfusion.

Results: IBL for the control group was 783.33±332.71 mL and for intervention group 410.57±189.72 mL (p<0.001). The operative time for control group was 3.24±0.38 hours and for intervention group 2.99±0.79 hours (p<0.695). Hemovac drainage on days 1 and 2 for control group was 167.10±53.83 mL and 99.33±37.5 mL, respectively, and for intervention group 107.03±44.37 mL and 53.38±21.99 mL, respectively (p<0.001). The length of stay was significantly shorter in the intervention group (4.8±1.1 days) compared to control group (7.0±2.3 days). The cost of treatment in the intervention group was US dollar (USD) 4,552.57±1,222.6 compared with that in the control group USD 6,529.9±1,505.04.

Conclusions: Topical TXA is a viable, cost-effective method of decreasing perioperative blood loss in major spine surgery with fewer overall complications than other methods. Further studies are required to find the ideal dosage and timing.

키워드

Spine surgery; Topical; Tranexamic acid; Surgical blood loss; Cost-effectiveness

원문 및 링크아웃 정보

 

등재저널 정보