The effect of single-dose, preoperative intravenous tranexamic acid on early postoperative pain scores after rotator cuff repair: a double-blind, randomized controlled trial

Mackenzie, Samuel P.; Spasojevic, Miloš; Smith, Margaret M.; Mattern, Owen; Piggott, Robert Pearse; Patel, Shaan S.; Bedaiwy, Najla; Cass, Benjamin; Young, Allan

doi:10.1016/j.jse.2022.02.023

Cited by 14 publications

(21 citation statements)

References 35 publications

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“…The full text was not found in one article. We finally included the following seven studies in this meta-analysis: Takahashi et al [ 15 ], Bayram et al [ 18 ] Mackenzie et al [ 14 ], Liu et al [ 11 ], Ersin et al [ 12 ], Gao et al [ 19 ], and Nicholson et al [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of these, two were conducted in China, two in Turkey, one in the United States, one in Japan, and one in Australia. Of these included RCTs, three were level I evidence [ 14 , 15 , 18 ] and four were level II evidence [ 11 , 12 , 19 , 20 ]. All of the included studies comprised patients undergoing arthroscopic rotator cuff repair.…”

Section: Resultsmentioning

confidence: 99%

“…All of the included studies comprised patients undergoing arthroscopic rotator cuff repair. Six trials used general anesthesia [ 11 , 12 , 14 , 15 , 19 ]. One of them was combined with an echo-guided interscalene plexus block [ 14 ].…”

Section: Resultsmentioning

confidence: 99%

“…Six trials used general anesthesia [ 11 , 12 , 14 , 15 , 19 ]. One of them was combined with an echo-guided interscalene plexus block [ 14 ]. Another study performed a preoperative interscalene brachial plexus nerve block [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…However, for the image quality of the individual stages of the operations, the difference found was not statistically significant [ 12 ]. Additionally, Mackenzie et al [ 14 ] and Takahashi et al [ 15 ] concluded that TXA did not improve postoperative pain scores after RCR in a double-blind, randomized controlled trial.…”

Section: Introductionmentioning

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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