Preoperative Systemic Administration of Acid Tranexamic to Reduce Intraoperative Bleeding in Arthroscopic Rotator Cuff Repair

Cenatiempo, Mauro; Distefano, Marco; Tucci, Raffaele; Bella, Leonardo di; Chiaracane, Giusto; Marotta, Teodoro

doi:10.1016/j.jse.2021.03.118

Cited by 1 publication

(3 citation statements)

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“…They demonstrated improved visualization and early postoperative pain scores. The same effect was concluded in other reports [ 12 , 13 ]. However, for the image quality of the individual stages of the operations, the difference found was not statistically significant [ 12 ].…”

Section: Introductionsupporting

confidence: 91%

“…It was clear that all of the prespecified and expected outcomes of interest were reported in all studies. Published bias could not be conducted for only seven studies, but was increased by a trial with only the abstract and by nine ongoing trials [ 13 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

Section: Resultsmentioning

confidence: 99%

“…Bayram proved that adding TXA to the irrigation fluid during arthroscopic RCR provides visual quality similar to that of epinephrine, which has been certified to decrease blood loss and improve arthroscopic visualization [ 4 , 31 , 32 ]. Cenatiempoa et al [ 13 ] reported significantly lower bleeding during surgery ( p = 0.018) in the TXA group in the public abstract. Five studies assessed the visual field in the operation in different manners [ 11 , 12 , 15 , 18 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and Safety of Tranexamic Acid in Shoulder Arthroscopic Surgery: A Systematic Review and Meta-Analysis

Sun

Xiao

et al. 2022

JCM

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Background: Visual clarity during shoulder arthroscopy can ensure an efficient and effective performance of the procedure, and it is highly related to bleeding without a tourniquet. Tranexamic acid (TXA) is widely used in adult reconstruction procedures; however, its use in shoulder arthroscopic operations is a relatively novel topic. Purpose: To analyze the available literature on visual clarity, blood loss, pain control, functional outcomes, and complications after the administration of tranexamic acid in shoulder arthroscopic surgery. Methods: A literature search was performed to retrieve randomized controlled trials examining the use of tranexamic acid at the time of shoulder arthroscopic surgery. The literature search included the MEDLINE, Embase, Web of Science, and Cochrane Library databases. The primary outcomes included visual clarity, blood loss, and visual analog scale scores for pain. Secondary outcomes were operative time, irrigation amount used, postoperative shoulder swelling, the need for pressure increase, mean arterial pressure (MAP), functional outcomes, postoperative adverse effects such as deep venous thrombosis, and pulmonary embolism. The outcomes were pooled to perform a meta-analysis. Results: Seven prospective randomized controlled trials met the inclusion criteria for analysis. All of the included studies performed arthroscopic rotator cuff repair. No significant difference in visual clarity was observed (SMD (standardized mean difference), 0.45 [95% CI(confidence interval), −0.68, 1.59]; p = 0.44) nor in pain score (MD (mean difference), −0.46 [95% CI, −0.97, 0.05]; p = 0.08) between the TXA group and the control group. Two studies found no significant difference in blood loss between the TXA group and the control group. The meta-analysis from five studies demonstrated no significant difference between the TXA and control groups in operative time (MD, −3.51 [95% CI, −15.82, 8.80]; p = 0.58) or irrigation amount used (MD, −2.53 [95% CI, −5.93, 0.87]; p = 0.14). Two trials reported different statistical results in postoperative shoulder swelling. No significant differences regarding the need for pressure increase and MAP were reported between groups. No wound complications or infections or cardiac, thrombotic, or thromboembolic complications were recorded in either group. Conclusion: The use of intravenous or local TXA in shoulder arthroscopic surgery did not increase complications or thromboembolic events, but TXA had no obviously effect of reducing bleeding to obtain a clear visual field or pain release in patients undergoing shoulder arthroscopic surgery.

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Section: Introductionsupporting

confidence: 91%

Section: Resultsmentioning

confidence: 99%