Topical Tranexamic Acid Does Not Affect Electrophysiologic or Neurovascular Sciatic Nerve Markers in an Animal Model

Schwarzkopf, Ran; Dang, Phuc N.; Luu, Michele; Mozaffar, Tahseen; Gupta, Ranjan

doi:10.1007/s11999-014-4098-4

Cited by 8 publications

(6 citation statements)

References 38 publications

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“…There is an important experimental study to answer this question. Schwarzkopf et al [ 29 ] sought to examine the effect of the topical application of TXA on the sciatic nerve in rats. They exposed the sciatic nerve and then administered subtherapeutic (1 mg/kg), therapeutic (10 mg/kg), and supratherapeutic (100 mg/kg) concentrations of topical TXA.…”

Section: Discussionmentioning

confidence: 99%

“…They exposed the sciatic nerve and then administered subtherapeutic (1 mg/kg), therapeutic (10 mg/kg), and supratherapeutic (100 mg/kg) concentrations of topical TXA. They suggested that there were no electrophysiologic and histologic effects on the sciatic nerve, for up to 1 month [ 29 ]. Since the spinal cord will be completely exposed after laminectomy, the dose of the TXA in the topical application becomes important; therefore, we would like to emphasize that topical application should be treated with caution.…”

Section: Discussionmentioning

confidence: 99%

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Is Tranexamic Acid an Effective Prevention in the Formation of Epidural Fibrosis? Histological Evaluation in the Rats

Çirçi¹,

Atıcı²,

Barış³

et al. 2023

J Korean Neurosurg Soc

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Objective : The present study aimed to determine the topical and systemic efficacy of tranexamic acid (TXA) on epidural fibrosis in a rat laminectomy model.Methods : Thirty-two 12-month-old adult Sprague-Dawley rats were used in this study. Each rat underwent bilateral laminectomy at the L1 and L2 vertebral levels. Rats were divided into four groups : in group I (control group, n=8), a laminectomy was performed and saline solution was applied into the surgical space. In group II (topical group, n=8), laminectomy was performed and 30 mg/ kg TXA was applied to the surgical site before skin closure. In group III (systemic group, n=8), 30 mg/kg TXA was administered intravenously via the tail vein in the same session as the surgical procedure. In group IV (topical and systemic group, n=8), TXA was administered 30 mg/kg both topical and intravenous. The rats were sacrificed at 4 weeks postoperatively. Masson’s trichrome and hematoxylin and eosin were used to assess acute inflammatory cells, chronic inflammatory cells, vascular proliferation, and epidural fibrosis.Results : Epidural fibrosis, acute inflammation, chronic inflammation, and sum histologic score value were significantly lower in the systemic TXA group, systemic and topical TXA groups than in the control group (<i>p</i><0.05). In addion, the sum histologic score was significantly lower in the topical TXA group than in the control group (<i>p</i><0.05).Conclusion : In this study, epidural fibrosis formation was prevented more by systemic application, but the topical application was found to be effective when compared to the control group. As a result, we recommend the systemic and topical use of TXA to prevent epidural fibrosis during spinal surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is Tranexamic Acid an Effective Prevention in the Formation of Epidural Fibrosis? Histological Evaluation in the Rats

Çirçi¹,

Atıcı²,

Barış³

et al. 2023

J Korean Neurosurg Soc

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“…First, the rats were anesthetized with 100 mg/kg intramuscular sodium ketamine hydrochloride (Alphamine, Egevet, 100 mg/mL) and 20 mg/kg intramuscular xylazine (Alfazyne, Egevet, 2%) using a 30 G needle. The therapeutic dose (10 mg/kg) was selected for the dose of TXA to be used topically and IV, and diluted accordingly [15,17]. The same amount of saline solution was also prepared to ensure standardization.…”

Section: Surgical Procedurementioning

confidence: 99%

“…Especially, the effects of TXA on cartilage have been heavily studied [13,14]. Periarticular tissues outside of the cartilage and their effects on the sciatic nerve have been included in different research as well [15,16].…”

Section: Introductionmentioning

confidence: 99%

Is tranexamic acid safe for the hip joint?

Akcaalan,

Akcan,

Tufan

et al. 2023

Naunyn-Schmiedeberg's Arch Pharmacol

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Backround: To show the effects of tranexamic acid, which is a drug frequently used in bleeding control, on the hip joint and sciatic nerve with animal experiments. Methods: There were 15 rats in each of the 3 groups, totaling 45 rats. Topical saline injections were applied to the rst group, topical TXA injections to the second group, and intravenous (IV) TXA injections to the third group. In the samples taken from the hip joint three weeks later, femoral head cartilage , sciatic nerve and joint capsule thicknesses were analyzed histologically.Results: Statistically signi cantly more cartilage degradation was detected in the femoral head cartilage in both the IV and intraarticular TXA group when compared to the control group.The groups were also compared in terms of acetabular cartilage; however, no histological difference was found between the groups.It was seen that when the femoral head cartilage thickness (the average of the measurements made from 3 different points were used) the cartilage thickness in the topical TXA group was less when compared to the other 2 groups. However, this difference was determined to not be statistically signi cant. The data of the hip joint capsule thickness measurement , it was found that the capsule thickness in the topical TXA applied group was less when compared to the other 2 groups. However, this difference was not statistically signi cant. When all 3 groups were compared in sciatic nerve no different staining characteristics were found in the immuno uorescence examination. Conclusion: Txa, which is frequently used in orthopedic practice, shows negative effects on hip joint cartilage in both topical and intravenous application. 20/01/2022, Number: 684).

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“…All rats were randomized into four groups by using sealed envelopes. Local tranexamic acid (Transamin 100 mg/ml, Teva İlaç, İstanbul) were determined on the basis of previously conducted studies: 1 mg/kg (D1 group), 10 mg/kg (D10 group), 100 mg/kg (D100 group), and no tranexamic acid (D0 group) 21) . Two rats in the D0 group died after the radiographic examination.…”

Section: Experimental Designmentioning

confidence: 99%

Effect of Local Tranexamic Acid on the Quality of Bone Healing in a Rat Spinal Fusion Model

Şahin

Berk

Özkal

et al. 2022

Spine Surg Relat Res

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Introduction:The use of the antifibrinolytic agent tranexamic acid has positive effects on bleeding control, but our knowledge is still limited regarding how fibrinolysis suppression changes the process of bone formation and the quality of bone. Because of the several side effects of systemic tranexamic acid, topical usage has been established in several procedures. This study aimed to investigate the effect of local tranexamic acid on vertebral fusion by using macroscopic, radiologic, and microscopic techniques. We also attempted to determine the safe dose range in case some doses had negative effects on fusion.Methods: Twenty-eight Wistar albino rats underwent intertransverse fusion. All rats were randomized into four groups: groups treated with local tranexamic acid doses of 1 mg/kg (D1), 10 mg/kg (D10), and 100 mg/kg (D100) and the control group with no drug (D0). At the end of the eighth week, all rats were sacrificed for evaluation in terms of palpation, mammography, and histopathologic analysis. Results:The manual palpation results presented with lower fusion rates in D10 and D100 groups than in the control group. Radiological examination results were significantly higher in the control group. The histopathologic examination revealed no significant differences between groups in the percent of new bone formation. Conclusion:Our results showed that local administration of tranexamic acid reduced the quality and stability of fusion without a delay in bone formation. However, doses of 1 mg/kg did not reduce the stability in the palpation test. Our findings suggest that 1 mg/kg dose is a critical threshold above which tranexamic acid reduced the bone healing process of fusion and that surgeons should consider the doses of local tranexamic acid during surgery.

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Topical Tranexamic Acid Does Not Affect Electrophysiologic or Neurovascular Sciatic Nerve Markers in an Animal Model

Abstract: Topical tranexamic acid is effective in decreasing patient blood loss during THA, and results from our in vivo rat model study suggest there may be no electrophysiologic and histologic effects on the sciatic nerve, with the numbers available, up to 1 month.

Cited by 8 publications

References 38 publications

Is Tranexamic Acid an Effective Prevention in the Formation of Epidural Fibrosis? Histological Evaluation in the Rats

Is Tranexamic Acid an Effective Prevention in the Formation of Epidural Fibrosis? Histological Evaluation in the Rats

Is tranexamic acid safe for the hip joint?

Effect of Local Tranexamic Acid on the Quality of Bone Healing in a Rat Spinal Fusion Model

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