Use of Tranexamic Acid at Knee Joint Arthroplasty

Abstract


Results of comparative study of the efficacy and safety of intraoperative application of tranexam versus autoplasma in patients with planned surgical blood loss and high risk of venous thrombosis development has been presented. One hundred seven patients admitted for total knee replacement were divided into 2 groups. In the main group (55 patients) intraoperative intravenous infusion of 10 mg/kg tranexam were used. In the control group (52 patients) intraoperative hemodilution with autoplasma was performed. Hemostasis indices (APTT, INR, SFMC, D- dimer) and lysis index were studied before surgery and in postoperative period. Ultrasound scanning of lower extremity veins was performed before surgery and in 4—5 days after intervention. The volume of intraoperative blood loss in two groups did not differ. In the postoperative period the drainage blood loss in the main group was more than twice lower as compared to the control group (p=0,037). In postoperative period statistically significant increase in SFMC and D-dimer indices was noted in both groups. However after tranexam application the increase in fibrin lysis products content was reliably less marked than in control group. US investigation of lower extremities showed distal veins thrombosis in 2 patients from control group and no cases of thrombosis in the main group.

Full Text

Применение транексамовой кислоты при эндопротезировании коленного сустава

About the authors

S. V Vlasov

Email: svlasof@rambler.ru

A. A Pronskikh


References

  1. Шевченко Ю.Л., Стойко Ю.М., Замятин М.Н., Карпов И.А., Теплых Б.А., Смолькин Д.А. Кровосберегаю- щий эффект транексамовой кислоты при протезировании коленного сустава. Общая реаниматология. 2008; IV (6): 21-24.
  2. Ellis M.H., Fredman B., Zohar E., Ifrach N., Jedeikin R. The effect of tourniquet application, tranexamic acid, and desmopressin on the procoagulant and fibrinolytic systems during total knee replacement. J. Clin. Anesth. 2001; 13: 509-513.
  3. Mahdy M., Webster N.R. Perioperative systemic haemostatic agents. Br. J. Anaesth. 2004; 93 (6):842-858.
  4. Gunaydin B., Z. Ozkose, S. Pezek. Recombinant activated factor VII and epsilon aminocaproic acid treatment of a patient with Glanzmann's thrombasthenia for nasal polipectomy. J. Anesth. 2007; 21 (1): 106-107.
  5. Копенкин С.С., Моисеев С.В. Профилактика венозных тромбоэмболических осложнений при эндопротези- ровании суставов. Хирургия. 2006; 1: 36-39.
  6. Власов С.В., Сафронов Н.Ф., Власова И.В., Тлеубаева Н.В. Факторы риска тромбогеморрагических осложнений при эндопротезировании коленного сустава. Политравма. 2009; 2: 36-41.
  7. Tengborn L. Fibrinolytic inhibitors in the management of bleeding disorders. Treatment of Hemophilia. 2007; 42: 15.
  8. Pan Y. Z., Wu В. М., Hong Х. S. The clinical significance of platelet activation during exercise-induced myocardial ischema. Chung Hua Nei Ко Tsa Chih. 1994; 33 (2): 106-108.
  9. Zufferey P., Merquiol F., Laporte S., Decousus H., Mismetti P., Auboyer C. et al. Do antifibrinolytics reduce allogeneic blood transfusion in orthopedic surgery? Anesthesiology. 2006; 105 (5): 1034-1046.
  10. Бессонов С.В., Орлецкий А.К., Кассиль В.Л. Особенности анестезиологического обеспечения эндопротези- рования крупных суставов нижних конечностей. Вестн. травматол. ортопед. 2005; 1: 85-90.

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Copyright (c) 2012 Vlasov S.V., Pronskikh A.A.

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