Volume 20 Issue 6
Jun.  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(6): 927-930
YANG Hui-hong, YAN Lei, XU Gui-ping. Effects of tranexamic acid and controlled hypotension on hemorrhage in spinal surgery[J]. Chinese Journal of General Practice, 2022, 20(6): 927-930. doi: 10.16766/j.cnki.issn.1674-4152.002489
Citation: YANG Hui-hong, YAN Lei, XU Gui-ping. Effects of tranexamic acid and controlled hypotension on hemorrhage in spinal surgery[J]. Chinese Journal of General Practice, 2022, 20(6): 927-930. doi: 10.16766/j.cnki.issn.1674-4152.002489
shu

Effects of tranexamic acid and controlled hypotension on hemorrhage in spinal surgery

doi: 10.16766/j.cnki.issn.1674-4152.002489

  • Department of Anesthesiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang 830001, China

Funds:

 2017D01C137

  • Received Date: 2021-06-15
    Available Online: 2022-09-21
    Abstract
  •   Objective  To investigate the effect of tranexamic acid combined with controlled hypotension on perioperative bleeding after spinal surgery.  Methods  A total of 120 spinal surgery patients in the People ' s Hospital of Xinjiang Uygur Autonomous Region from January 2019 to February 2020 were selected and divided into 3 groups by random number table method: S group, TXA group and TXA + CH group. In S group, 0.2 mL/kg of normal saline was intravenously injected immediately after anesthesia induction, and was pumped at a rate of 0.1 mL/(kg·h) until the end of surgery. TXA group was injected with tranexamic acid 20 mg/kg at a rate of 10 mg/(kg·h) by intravenous pump until the end of operation. In the TXA+CH group, on the basis of the TXA group, sodium nitroprusside was pumped for controlled blood pressure until the main operation was completed. The indicators before and 1 day after operation and the occurrence of adverse events in one week after operation were recorded.  Results  Compared with S group, intraoperative blood loss in TXA group and TXA+CH group [(434.2±73.4) mL vs. (287.6±73.6) mL vs. (236.2±59.4) mL], postoperative drainage volume [110.0 (91.3, 145.0) mL vs. 77.5 (60.0, 95.0) mL vs. 60.0 (50.0, 70.0) mL], intraoperative visual field quality score [(3.3±0.5) points vs. (2.4±0.5) points vs. (2.2±0.4) points], days of hospitalization [8.5 (7.0, 15.0) d vs. 6.5 (5.0, 9.0) d vs. 6.0 (5.0, 7.8) d], the differences were statistically significant (all P < 0.05). Compared with TXA group, intraoperative blood loss and SSFQ score of TXA+CH group were decreased (all P < 0.05), and there was no significant difference in the length of hospital stay and 24-hour postoperative drainage volume (all P>0.05). There was no statistical significance in the biochemical indexes between the three groups before operation (all P>0.05). There were differences in RBC, HB, and HCT among the three groups at 1 d after operation (all P < 0.05). There were no adverse reactions in the three groups of patients.  Conclusion  Tranexamic acid can reduce blood loss in patients undergoing spinal surgery, and tranexamic acid combined with controlled hypotension has the best effect on reducing blood loss.

     

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