Evaluation of the use of tranexamic acid in the postoperative period in patients with scoliosis undergoing posterior fusion

Abstract

Introduction: Scoliosis is the most prevalent type of spinal deformity, with a 2-3% prevalence in the general population. Moreover, surgery for scoliotic deformity may result in severe blood loss and, consequently, the need for blood transfusions, thereby increasing surgical morbidity and the rate of complications. Several anti brinolytic drugs have been regarded as safe and effective options for reducing blood loss, among these drugs, the tranexamic acid. Therefor the present study aimed to analyze the effectiveness of this drug for controlling bleeding when used intraoperatively and in the rst 48 h after surgery.Methods: A prospective randomized study of a cohort of patients included in a mass event for scoliosis treatment using PSF was performed. Twenty-eight patients were analyzed and divided into two groups: 14 patients were selected for intraoperative and postoperative use of tranexamic acid (TXA), and the other 14 were selected only during the intraoperative period. The drainage bleeding rate, length of hospital stay, number of transfused blood units, and rate of adverse clinical effects were compared.Results: All the patients involved had a similar number of fusion levels addressed and a similar scoliosis pro le. The postoperative bleeding rate through the drain did not signi cantly differ between the two groups (p > 0.05). There was no signi cant difference in the number of transfused blood units between the groups (p=0.473); however, in absolute numbers, patients in the control group received more transfusions. The length of hospital stay was fairly similar between the groups, with no statistically signi cant difference. Furthermore, the groups had similar adverse effects (p=0.440), with the exception of nausea and vomiting, which were twice as common in the TXA group postoperatively than in the control group.Conclusions: No signi cant differences were found in the effective use of TXA during the rst 48 postoperative hours.