Evaluation of the activity of tranexamic acid administration in total hip arthroplasty on bleeding and blood transfusion

Background and aim: In this study, we aimed to investigate the effects of tranexamic acid administration before incision on bleeding, blood transfusion, fibrin degradation products and renal function in patients undergoing total hip arthroplasty. Methods: After obtaining ethical approval; ASA I-III, ninety patients aged between 18-75 years undergoing total hip arthroplasty were encluded to the study. The patients were randomly assigned. In all subjects, blood samples were taken before surgery in order to study Hgb, hct, platelet count, PT, PTT, fibrinogen, D-dimer, BUN, creatinine. Fascia iliac compartment block (FICB) and spinal anesthesia were applied to the patients. Group 1 was given 30 mg / kg (max 2.5 g) TA and Group 2 was given 15 mg / kg (max 1.2 g) before surgery. The amount of intraoperative and postoperative bleeding was recorded. Blood products given intraoperatively and postoperatively were recorded. Blood samples were taken again at 0th 1st, 2nd and 6th hours postoperatively. Results: There was no difference between the groups in terms of demographic, intra-operative and postoperative blood transfusion, Hgb, Hct, Plt, fibrinogen, D-dimer, creatinine, BUN. While the INR result in group 2 was higher than the other group, aPTT was higher in Group 1 patients at 6 hours. According to intragroup statistics, Hgb, Hct and Plt values at the 6th hour in both groups were statistically lower than the preoperative values. Group 1's postoperative 6th hour; INR and aPTT values were statistically significantly higher than preoperative values. Group 2 postoperative 6th hour; The INR value was statistically significantly higher than the preoperative. Conclusion: The use of TA, which is effective in providing bleeding control in hip replacement surgery, at the preoperative doses of 15 mg / kg and 30 mg / kg, decreased the amount of bleeding and blood transfusion similarly in both groups at postoperative 0, 1, 2 and 6 hours. Keyword: Hip replacement surgery, tranexamic acid, bleeding, blood transfusion