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· DOS Abstracts
The Effect of Tranexamic Acid on Duration of Surgery
and Complications. A double blind, randomized
study of patients undergoing lumbar spine surgery.
Preliminary report
Signe Forbech Elmose, Else Bay Andersen, Mikkel Østerheden Andersen
Center for Spine Surgery and Research, Middelfart Hospital; Department
of Anesthesiology, Vejle Hospital; Center for Spine Surgery and Research,
Middelfart Hospital
Background:
Studies have shown that the antifibrinolytic drug TXA reduces
blood loss during major spine surgery. There are no studies on the effect of TXA
in minor lumbar spine surgery and no studies investigate the effect of TXA on
OP-time.
Purpose / Aim of Study:
We investigate the effect of tranexamic acid (TXA)
compared to placebo in low- risk adult patients undergoing elective minor lum-
bar spine surgery. Primary objective is operative time (OP-time) and second-
ary objectives estimated perioperative (peri-OP) blood loss, incidence of dural
tears, postoperative symptomatic spinal epidural hematomas (SEH) and venous
thromboembolic events (VTE).
Materials andMethods:
A clinical double blind randomized, placebo-controlled
study. We included 220 patients (ASA 1-2), undergoing lumbar decompressive
surgery at Middelfart Hospital. Exclusion criteria; thromboembolic disease, co-
agulopathy, hypersensitivity to TXA or history of convulsion. Randomization by
blocks of 10, in two groups, TXA or placebo. Anticoagulation therapy was dis-
continued 2-7 days preoperatively. Patients received pre-incision either a bolus
of TXA (10mg/kg IV), or an equivalent volume of placebo (saline). Statistics:
Students t-test, Wilcoxon Mann-Whitney or chi2-test, significance level
p=0.05.
Findings / Results:
14 patients were excluded, 206 analyzed (TXA-group
n=103, placebo- group n=103). The groups had an unequal sex ratio TXA
49/51 and placebo 33/67 (female/male, %), otherwise comparable by basic
demographics. There was no significant difference in OP-time. Statistical signifi-
cant difference in estimated post-OP blood loss, median TXA 5ml (n=59) and
placebo 21ml (n=64), p<0.001. No difference in per- OP blood loss or dural
tears. No SEH or VTE.
Conclusions:
A single dose of TXA can significantly reduce the post-OP blood
loss in minor lumbar spine surgery on low-risk adult patients.
No conflicts of interest reported
45.