The Effect of Tranexamic Acid Injection on Hemoglobin Level, Albumin Level, and Pain on Patient Receiving Total Knee Replacement

Abstract

Background: The high number of knee osteoarthritis cases could lead arthroplasty more frequent. Total Knee Replacement (TKR) surgery procedure is at risk of massive bleeding. Bleeding can affect albumin levels and the onset of intra-compartment pressure on the nerves. The use of tranexamic acid could be done to reduce bleeding.Objective: Proving the effect of intravenous tranexamic acid administration on patients who will undergo TKR surgery.Methods: The experiment was conducted experimentally using primary laboratory data obtained before and after surgery in patient which will be performed TKR operation starting from April 2017.Result: There are 64 patients who had undergone total knee replacement surgery. The mean preoperative hemoglobin in the tranexamic acid group and without tranexamic acid was 13.06±1.46g/dl and 12.44±0.87g/dl. The mean hemoglobin after surgery was 10.29 ±1.14 g/dl and 9.16±0.97 g/dl. In the group receiving tranexamic acid, 32 (100%) reported low postoperative VAS scores, did not require blood transfusions and did not require albumin transfusion. Groups not receiving tranexamic acid, 32 (100%) moderate postoperative VAS scores, 4 people (12.5%) required the blood transfusion, and 3 (9.4%) required transfusion of albumin.Conclusion: The results of this study showed that the group given tranexamic acid had higher hemoglobin levels after surgery than the untreated group of tranexamic acid; there was no difference in albumin levels after surgery in both groups; the administration of tranexamic acid will decrease the amount of blood loss, decrease the degree of pain, and decrease the need for blood transfusions after total knee replacement surgery.

<p><strong>Efektivitas ekstrak daun cocor bebek (kalanchoe pinnata) terhadap waktu perdarahan (bleeding time) pada ekor mencit strain balb-c</strong></p><p><strong><em>Effectiveness of kalanchoe pinnata leaf extract on bleeding time in the tail of balb-c mice strain</em></strong></p>

“…Apabila plasmin berhasil berikatan, plasmin dapat memecah ikatan fibrin dan memecah bekuan fibrin menjadi fragmen-fragmen. 23 Kelompok dosis 0,1 mg/gr BB (P1), kelompok dosis 0,2 mg/gr BB (P2), kelompok dosis 0,3 mg/gr BB (P3) memiliki kemampuan memperpendek waktu perdarahan dibandingkan kelompok K(-). Hal ini disebabkan karena ekstrak daun cocor bebek diduga memiliki aktivitas hemostasis memperpendek waktu perdarahan yang berasal dari senyawa flavonoid, tanin dan saponin.…”

Platelet rich plasma could replace tranexemic acid in total knee replacement? A comparative study between their postoperative- bleeding hemostatic effects

“…In addition, it may be a cause for development of hematomas causing pain, limiting the ROM, extending hospital stays beside demanding blood transfusion which might be associated with several undesirable adverse result (as sepsis, circulatory overload, or allergy). Accordingly, reducing the blood loss may escape these distressing states 2 …”

“…Accordingly, reducing the blood loss may escape these distressing states. 2 It has been recognized that both Tranexamic acid (TXA) and Platelet-rich plasma (PRP) play a vast part in decreasing blood loss during knee arthroplasty. 3 Tranexamic acid is antifibrinolytic material that break plasminogen stimulation through hindering the lysine binding site of plasminogen in addition to avoiding the development of plasmin, and so boost coagulation procedure.…”