Intra-operative Administration of intravenous TXA twice at a Dose of 1000 mg and Reduction of Perioperative Blood Loss in Posterior Lumbar Spine Decompression, Instrumentation, and Fusion Surgery in Degenerative Lumbar Stenosis and Spondylolisthesis
คำสำคัญ:
VAS = Visual analog pain scale, TXA = Tranexamic acidบทคัดย่อ
Introduction : Degenerative lumbar stenosis and spondylolisthesis are the most common disease in clinical practice. Many patients with these diseases are required to undergo posterior decompression and fusion surgery. The surgical procedure results in massive perioperative blood loss and significantly negative outcomes on patients. The purpose of this retrospective study was to investigate the efficacy of intravenous TXA administration. Specifically, intravenous TXA administration was compared to non TXA administration in order to confirm its efficacy in reducing perioperative blood loss and blood transfusion requirements in posterior lumbar spine decompression, instrumentation, and fusion surgery.
Material and Methods : This retrospective study in degenerative lumbar stenosis and spondylolisthesis patients undergoing posterior decompression lumbar spine, instrumentation, at the Orthopedic Clinic of Mahasarakham Hospital between January 2019 - December 2020. Participants were divided into two groups, the intra-operative intravenous TXA administration group (the Study Group) and the non TXA administration group (the Control Group). The Study Group and the Control Group were compared regarding perioperative blood loss.
Results : The mean of perioperative blood loss in the Study Group (1067.32ml±367.14) decreased significantly (t-test = -4.244, p-value = 0.003) compared to the Control Group (1609.30ml±748.18). The blood transfusion requirement in the Study Group decreased significantly compared to the Control Group in the intra-operative, postoperative and perioperative periods (p-value = 0.002, 0.009, and 0.002, respectively). By using the odds
ratio to analyze blood transfusion incidents, the Control Group showed five times of blood transfusion incidents higher than the Study Group in all of three periods(odds ratio = 0.197, 0.279, and0.232).
Conclusion : Intra-operative administration of intravenous TXA twice at a dose of 1000 mg is simple, safe, and efficacious in reducing the perioperative blood loss and blood transfusion requirements in patients undergoing posterior lumbar decompression, instrumentation, and fusion surgery.
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