Efficacy of topical versus intravenous tranexamic acid in spinal deformity
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Purpose To compare topical tranexamic acid versus intravenous tranexamic acid in reducing intra- and postoperative blood loss and transfusion rate in deformity patients. Materials and method We performed a retrospective cohort study with posterior fusion deformity patients, between 2009 and 2016. Patients were categorized in 4 groups: "No TXA" (n = 35) if the wound was packed with saline soaked sponges, "IV TXA" (n = 37) the patient received 20 mg/kg bolus at the beginning of the surgery followed by continuous infusion of 1 mg/kg/hr until closure, "Topical TXA" (n = 23) the wound was packed with sponges soaked in 6 g of TXA diluted in a 3 L saline solution, or "Combined TXA" (n = 86) the patient received both IV and topical TXA. The primary outcomes were total, intra- and postoperative blood loss, surgical time, postoperative Ht/Hb, transfusion rates, and duration of drain insertion. Results A total of 181 patients were analyzed (78.6%F, 15.08 yo). No differences were found in total and intraoperative blood loss, surgical time, postoperative Ht/Ht, and transfusion rates. "Combined TXA" group had significantly less postoperative bleeding than "no TXA" group (p = 0.022). IV TXA patients (with o/without topical TXA) removed drains one day earlier than the no TXA group (p = 0.002). There were no complications related to the use of tranexamic acid. Conclusion There is significant decrease in postoperative bleeding in pediatric deformity patients with combined topical and IV tranexamic acid.
Artículo de publicación ISI
Quote ItemEuropean Spine Journal Aug 2020
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