Effect of peroperative local tranexamic acid admistration on bleeding in total knee arthroplasty performed with general or spinal anesthesia

Authors : Bahadır Balkanlı, İsmail Tüter, Enver İpek

Pages : 256-269

Doi:10.31362/patd.1500706

View : 96 | Download : 145

Publication Date : 2025-04-01

Article Type : Research Paper

Abstract :Purpose: This retrospective study aimed to compare the effects of local tranexamic use on postoperative bleeding in total knee arthroplasty performed under general or spinal anesthesia. Materials and methods: This study analyzed the amount of postoperative bleeding in 95 primary osteoarthritis knees that underwent total knee arthroplasty between 2017 and 2023. Patients who underwent general or spinal anesthesia were divided into four groups according to whether or not local tranexamic acid was administered perioperatively. Tranexamic acid was administered locally to the surrounding soft tissues after arthroplasty as 1 g. Postoperative hemogram changes, drain amounts, and transfusion needs were evaluated in the study. Results: In Group 4, a significant decrease in hemoglobin levels was observed within the first 24 hours postoperatively (p1:0.001; p2:0.000; p3:0.001). There was no statistically significant difference in hemoglobin values on the third day between Groups 1-4 (p:0.117). Postoperative hemoglobin values in Group 3 were statistically higher than the other groups (p1:0.019; p2:0.003). Significantly higher drain volumes were seen in Group 4 compared to Groups 1-3 (p=0.000). The amount coming from the drain in Group 1 was statistically significantly lower (p1:0.001; p2:0.032). When the replacement amount of 2 units (6.1%) was evaluated, blood replacement rates in Group 3 (6.1%) were lower than in the other groups (p1:0.002; p2:0.000). Discussion: The study found that locally applied tranexamic acid in total knee arthroplasty reduced postoperative bleeding, maintained hemoglobin levels, and reduced drainage volumes and transfusion requirements. It may contribute to reducing potential bleeding-related complications and costs.
Keywords : Traneksamik asit, diz artroplastisi, kan transfüzyonu, anestezi, cerrahi dren