Yonsei Med J.  2022 Oct;63(10):927-932. 10.3349/ymj.2022.0163.

Tranexamic Acid and Intraoperative and Postoperative Accumulative Bleeding in Elective Degenerative Spine Surgery

• Abdou M
• Kwon JW
• Kim HJ
• Lee B
• Choi YS
• Moon SH
• Lee BH

• KMID: 2533388
• DOI: http://doi.org/10.3349/ymj.2022.0163

Abstract

Purpose
Spinal surgeries are often associated with a high incidence of perioperative blood loss, which poses several complications. Much current research focuses on the importance of antifibrinolytic drugs during spinal surgeries to reduce blood loss, which can also reduce the risk of the need for blood transfusions. We evaluated the effects of prophylactic, low-dose tranexamic acid (TXA) in spinal fusion surgeries on blood loss, blood transfusions, and associated complications.
Materials and Methods
TXA was administered to 90 patients at a constant infusion rate of 10 mg/kg for 20 minutes after anesthesia induction, followed by a maintenance dose of 1 mg/kg/h until the end of the operation. An additional 91 patients were included as controls.
Results
There were no significant differences between the study groups in terms of intraoperative blood loss, which was 500 mL for both groups (p>0.999). Also, intraoperative blood transfusion requirements were similar between both groups (p=0.330). Mean blood transfusion amounts were 125±35 mL for patients in the TXA group and 85±25 mL in the control group. However, there was a significant reduction in postoperative blood transfusion (p=0.003) in the TXA group. Only three cases in the TXA group required blood transfusion, while 15 cases in the control group did.
Conclusion
We confirmed that low dose TXA has no effect on intraoperative blood loss volume or blood transfusion requirements and that it can significantly reduce the need for postoperative blood transfusions.

Keyword

Blood loss; blood transfusion; intraoperative; PLIF; postoperative; tranexamic acid