Et dosis-respons-studie af tranexamsyre. Effekten på kvalme og blodtab efter primaer knaealloplastik
Engelsk titel: A dose-response study of tranexamic acid. The effect on nausea and blood loss after total knee replacement
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Författare:
Veien M
;
Juelsgaard P
Email: mveien@dadlnet.dk
Språk: Dan
Antal referenser: 14
Dokumenttyp:
RCT
UI-nummer: 05041505
Sammanfattning
Introduction: Extensive loss of blood in total knee replacement (TKR) surgery is well known and is associated with a high rate of transfusion of allogenic blood. Tranexamic acid (TXA) has been shown to reduce the loss of blood by 50% in this patient group. A common side effect of TXA is nausea. Therefore, the goal of this study was to perform a dose-response study of TXA to determine whether the number of episodes of nausea could be reduced while preserving the antifibrinolytic effect of the drug. Materials and methods: Thirty-one consecutive patients scheduled to undergo TKR were randomized to receive either two doses of TXA (10 mg/kg) at a three-hour interval (group A) or one dose of TXA (10 mg/kg) (group B). The loss of blood, number of transfusions and episodes of nausea were registered. The treatment of nausea was standardized Results: The total loss of blood in group A was 313.8 ± 227.0 mL and in group B was 745.4 ± 281.3 mL (p< 0.001). Ten of the 17 patients (58.8%) in group A and 9 of the 14 patients (64.3%) in group B experienced nausea. None of the patients received allogenic blood. Discussion: We conclude that TXA (10 mg/kg) should be given twice at a three-hour interval to reduce the loss of blood, since reduction of the dose did not result in a reduction in the number of episodes of nausea and did allow a greater loss of blood.