Eliminating the use of allogeneic blood products in adolescent idiopathic scoliosis surgery

Berney, Mark; Dawson, Peter; Phillips, Margaret; Lui, Darren F; Connolly, Paul

doi:10.1007/s00590-015-1624-3

Cited by 25 publications

(26 citation statements)

References 26 publications

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“…Typically, any intervention evaluated in a randomized controlled trial only reduces more than 25%, which calls for attention. [11,13,14] The 13% reduction of the total blood loss could not provide reliable evidence for the usage of TA. The present study manifested administering 30 mg/kg initial dose and 2 mg/kg/h maintenance dosage, which lessened 41% total blood loss.…”

Section: Discussionmentioning

confidence: 99%

“…[19] Previous studies demonstrated that TA could inhibit the fibrinolytic activity and decrease blood loss in spinal deformity surgery or long segment fixation and fusion surgery. [9,11–13,25] Elwatidy et al [25] showed that TA reduced 49% blood loss in the spinal surgery. Berney et al [11] reported that TA decreased nearly 50% intraoperative estimated blood loss in adolescent idiopathic scoliosis surgery.…”

Section: Discussionmentioning

confidence: 99%

“…[9,11–13,25] Elwatidy et al [25] showed that TA reduced 49% blood loss in the spinal surgery. Berney et al [11] reported that TA decreased nearly 50% intraoperative estimated blood loss in adolescent idiopathic scoliosis surgery. The surgery for lumbar stenosis and spondylolisthesis is not identical to the deformity correction surgery or simple long segment fixation and fusion surgery.…”

Section: Discussionmentioning

confidence: 99%

“…These results showed the similar effect to those in previous studies. [9,11–14,16] The third difference with Wang et al was the administered dose regimen. More than 15 mg/kg is considered as a high dose regimen.…”

Section: Discussionmentioning

confidence: 99%

“…[9,11–17] Most of the previous studies focused on patients undergoing spinal correction surgery, [8,9,11,12,16,17] and only a few studies were involved in the patients undergoing posterior lumbar surgery for stenosis or spondylolisthesis. [15,18] Since the surgical procedure for stenosis or spondylolisthesis is not identical to spinal correction surgery, it can be correlated with extensive exposure, long-segment fixation, spinal canal decompression, interbody fusion, [3–5] and massive blood loss.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Tranexamic acid reduces perioperative blood loss of posterior lumbar surgery for stenosis or spondylolisthesis

Shi

Jiang

et al. 2017

Medicine

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Background:A prospective, randomized, double-blind, placebo-controlled study was performed. The routine usage of TA in spinal surgery is controversial. Only a few studies have focused on patients undergoing posterior lumbar surgery for stenosis or spondylolisthesis, although a large clinical cohort exists in the population. This study aimed to evaluate the effect and safety of TA in reducing perioperative blood loss in posterior lumbar surgery for stenosis or spondylolisthesis.Methods:100 eligible patients out of 126 were randomized to receive either a bolus dose of 30 mg/kg TA i.v, a maintenance dosage of 2 mg/kg/h TA, or an equivalent volume of normal saline. The pedicle screw system was used for fixing in all the patients, followed by decompression and posterior lumbar interbody fusion. The primary outcomes were intraoperative estimated blood loss and total blood loss. The secondary outcomes were receiving packed red blood cells and postoperative hemoglobin and hematocrit levels.Results:In total, 4 patients were excluded from the analyses, 50 patients were in the TA group, and 46 in the placebo group. The demographic and baseline data between the groups were not statistically different. The intraoperative estimated blood loss and the total blood loss were 33% and 41% lower in the TA group than the placebo group, respectively. The blood transfusion rate did not vary significantly (P = 0.191). Except a patient with a dural tear in the placebo group, no other complications were observed.Conclusion:TA significantly reduced the perioperative blood loss in patients undergoing posterior lumbar surgery for stenosis or spondylolisthesis.

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Section: Discussionmentioning

confidence: 99%