Neeru, Valsamma Abraham, Melchisedec Singh

ABSTRACT

Background and Aims:The major surgical procedures are associated with excessive blood loss and necessitate the need for blood transfusion in the absence of blood conservation strategies. Tranexamic acid (TXA) is a synthetic antifibrinolytic drug that competitively blocks the lysine-binding sites of plasminogen, plasmin, and tissue plasminogen activator, thereby inhibiting fibrinolysis and blood clot degradation. The aim of this study was to compare the efficacy of single intravenous bolus dose of tranexamic acid with bolus plus infusion dose of tranexamic acid in reducing intraoperative blood loss. Methods: This study was conducted as prospective, randomized and controlled.120 patients of either sex, ASA grade I and II and aged between 18 to 65 years were included in the study. These patients were randomly divided into 3 groups i.e. Group A (bolus), Group B (bolus + infusion) and Group C(control).Intraoperative blood loss and blood transfusions were noted. Post operative haemoglobin was done at 6 hours and the results were compared with preoperative haemoglobin levels. Results:The Placebo group had more blood loss and requirement of transfusion as compared to the TXA (both Bolus and Infusion groups). The intra-operative blood loss was least in the Bolus group and was maximum in the placebo group.The use of TXA significantly reduced the transfusion requirements in major surgeries with the least amount of transfusion needed in the Infusion group. Conclusion:The use of TXA ( in bolus as well as the infusion) led to statistically significant reduction in blood loss and the requirement of transfusion.