Comparison of Two Methods of Bolus and Infusion of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty

Abstract B ackground :  So far , many studies  have been performed  to determine the optimal dose and regimen of tranexamic acid to reduce  preoperative and postoperative blood loss in primary total knee arthroplasty. In th e present  study, two different methods of administration (bolus and infusion) ,  were compared. Materials and Methods :  Forty patients were randomized in  the two groups  (A and B) of 20 patient s each . A ll patients received 500 mg tranexamic acid before  inflation of  tourniquet. Group A (mean age ,  64± 6.1 years) received 500 mg tranexamic acid  10  minutes before  loosening of  tourniquet and group B ( mean age,  63.5 ± 7.7 years) received 500 mg tranexamic acid  through  IV infusion during 6 hours from the time of tourniquet loosening (total dose of TA ,  1 g in both groups). Intraoperative blood loss, postoperative drainage (in 6 and 12 hours), blood transfusion (in 48 hours),  and decrease in  hematocrit  and hemoglobin  (6 and 12 hours later) ,  were compared between  the  two groups. R esults :  The patients in group B had  lower  intra- and postoperative  blood loss  in 6 and 12 hours and also had  lower decrease in  hemoglobin ,  and  their  packed cell transfusion rate was significantly lower compared to  the  group A. C onclusion :  The findings of this  study  indicated  that infusion administration of tranexamic acid in primary total knee arthroplasty ,  was more effective  in the reduction of  perioperative blood loss  as well as need  for blood transfusion in 48 hours.