Tranexamic Acid Reduces Perioperative Blood Loss in Cervical Laminoplasty

Tsutsumimoto, Takahiro; Shimogata, Mitsuhiko; Ohta, Hiroshi; Yui, Mutsuki; Yoda, Isao; Misawa, Hiromichi

doi:10.1097/brs.0b013e3181fb3a42

Cited by 82 publications

(101 citation statements)

References 25 publications

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“…Although it has been assessed in several studies, the efficacy and safety of TXA for perioperative blood loss reduction during spine surgery has not been clearly demonstrated. 3,[13][14][15] In this study, 2 doses of TXA significantly reduced perioperative blood loss, crystalloid and colloid administration, and blood transfusions in adult patients undergoing elective complex laminectomy. The overall incidence of blood transfusions in the TXA group was 15.3% compared with 43.5% in the control group.…”

Section: Discussionmentioning

confidence: 64%

Two Doses of Tranexamic Acid Reduce Blood Transfusion in Complex Spine Surgery

Raksakietisak

Sathitkarnmanee

Srisaen

et al. 2015

SPINE

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Section: Discussionmentioning

confidence: 64%

Two Doses of Tranexamic Acid Reduce Blood Transfusion in Complex Spine Surgery

Raksakietisak

Sathitkarnmanee

Srisaen

et al. 2015

SPINE

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“…The mechanism of action is During their randomized prospective study, they reported a reduction in blood loss in both intra-and postoperative time periods in adult patients who underwent cervical laminoplasty. 36 As a theoretical outcome of the initiation of TXA administration, our major concern was that the antifibrinolytic effect of this medication might lead to an increase in venous thromboembolic events. However, recent publications suggest that TXA does not result in an increase in thromboembolic events.…”

Section: Discussionmentioning

confidence: 99%

Does the Intraoperative Tranexamic Acid Decrease Operative Blood Loss During Posterior Spinal Fusion for Treatment of Adolescent Idiopathic Scoliosis?

Yagi

Hasegawa

Nagoshi

et al. 2012

Spine

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Study Design. Retrospective, observational study. Objective. To assess the effi cacy and safety of tranexamic acid (TXA) in decreasing operative blood loss and the need for transfusion during posterior spinal fusion for the treatment of idiopathic scoliosis in adolescents. Summary of Background Data. Blood loss associated with spinal surgery is a common potential cause of morbidity and often requires a blood transfusion, which subjects patients to the known risks of blood transfusion including transmission of diseases. Since the 1990s, intraoperative administration of antifi brinolytics has gained popularity. This study assesses the effi cacy and safety of TXA in controlling blood loss during posterior spinal fusion for the treatment of idiopathic scoliosis in adolescents at 1 institution. Methods. A retrospective comparative analysis of 106 consecutive adolescents undergoing posterior spinal fusion procedures at 1 institution was performed. Patients were analyzed according to treatment group: controls (63) and TXA (43). There were no signifi cant differences in demographic (age, sex, and comorbidities) or surgical traits (surgical time, number of fused vertebrae, preoperative hematocrit and hemoglobin) between the 2 groups. Results. TXA group had signifi cantly less intraoperative blood loss (613 ± 195 mL) than the control group (1079 ± 421 mL; P < 0.001) as well as postoperative blood loss (155 ± 86 mL and 263 ± 105 mL, respectively; P < 0.001). TXA group received signifi cantly less blood during the surgical procedure than the control group (258 ±

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“…10 Initial data supporting its effectiveness were from retrospective case series or heterogeneous cohort studies. [9][10][11][12][13][14][15] Subsequently, various prospective clinical trials analysed the performance of TXA in adolescents [16][17][18] and adults [19][20][21][22][23][24] undergoing several types of surgery of varying complexity, with divergent results. The 15 first meta-analysis on TXA use in spine surgery, published in 2008, 25 did not offer a clearly favourable recommendation because of the poor methodological quality of the studies included.…”

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confidence: 99%

“…4 The same reasoning would apply to TXA use in cervical surgery. Elwatidy and colleagues 19 and Tsutsumimoto and colleagues 20 failed to demonstrate efficacy of TXA in cervical 30 procedures, which is not surprising considering that patients with intraoperative bleeding volumes of less than 100 mL were included. Our results show that the larger the number of levels fused and the longer the duration of surgery, the more effective was TXA administration, coinciding with the findings of Peters 35 and colleagues.…”

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confidence: 99%

Intraoperative tranexamic acid use in major spine surgery in adults: a multicentre, randomized, placebo-controlled trial

Colomina

Koo

Basora

et al. 2017

British Journal of Anaesthesia

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Abstract15 Background. Perioperative tranexamic AQ5 acid (TXA) use can reduce bleeding and transfusion requirements in several types of surgery, but level I evidence proving its effectiveness in major spine surgery is lacking. This study was designed to investigate the hypothesis that TXA reduces perioperative blood loss and transfusion requirements in patients undergoing major spine procedures. Methods. We conducted a multicentre, prospective, randomized double-blind clinical trial, comparing TXA with placebo in 20 posterior instrumented spine surgery. Efficacy was determined based on the total number of blood units transfused and the perioperative blood loss. Other variables such as the characteristics of surgery, length of hospital stay, and complications were also analysed. Results. Ninety-five patients undergoing posterior instrumented spine surgery (fusion of >3 segments) were enrolled and randomized: 44 received TXA (TXA group) and 51 received placebo (controls). The groups were comparable for duration of 25 surgery, number of levels fused, and length of hospitalization. Transfusion was not required in 48% of subjects receiving TXA compared with 33% of controls (P ¼ 0.05). Mean number of blood units transfused was 0.85 in the TXA group and 1.42 with placebo (P ¼ 0.06). TXA resulted in a significant decrease in intraoperative bleeding (P ¼ 0.01) and total bleeding (P ¼ 0.01) relative to placebo. The incidence of adverse events was similar in the two groups. Conclusions. TXA did not significantly reduce transfusion requirements, but significantly reduced perioperative blood loss 30 in adults undergoing major spinal surgery.Clinical trial registration. NCT01136590.

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Tranexamic Acid Reduces Perioperative Blood Loss in Cervical Laminoplasty

Abstract: TXA significantly reduced perioperative blood loss, primarily through a reduction in postoperative blood loss, in cervical laminoplasty.

Cited by 82 publications

References 25 publications

Two Doses of Tranexamic Acid Reduce Blood Transfusion in Complex Spine Surgery

Two Doses of Tranexamic Acid Reduce Blood Transfusion in Complex Spine Surgery

Does the Intraoperative Tranexamic Acid Decrease Operative Blood Loss During Posterior Spinal Fusion for Treatment of Adolescent Idiopathic Scoliosis?

Intraoperative tranexamic acid use in major spine surgery in adults: a multicentre, randomized, placebo-controlled trial

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