VPB0636 - A Comparative Study Of Intravenous Bolus Versus Bolus With Continuous Infusion Of Tranexamic Acid To Reduce Blood Loss In Major Surgical Procedures

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Presenting Author(s)

NEERU NEERU, MBBS

Anaesthesia Registrar
Christian Medical College and Hospital, Ludhiana, Punjab
PATIALA, Punjab, India

Co-Author(s)

VA

VALSAMMA ABRAHAM

Professor, Department of Anaesthesia
Christian Medical College and Hospital, Ludhiana, Punjab
Ludhiana, Punjab, India

Background: The major surgical procedures are associated with excessive blood loss and necessitate the need for blood transfusion in the absence of blood conservation strategies. Allogeneic blood transfusion carries significant risks of immunological reactions, transmission of disease, hemolysis, coagulopathy, renal failure, admission to ICU and even death. Tranexamic acid (TXA) is a synthetic antifibrinolytic drug that competitively blocks the lysine-binding sites of plasminogen, plasmin, and tissue plasminogen activator, thereby inhibiting fibrinolysis and blood clot degradation.

Aims: The aim of this study was to compare the efficacy of single intravenous bolus dose of tranexamic acid with bolus plus infusion dose of tranexamic acid in reducing intraoperative blood loss.

Methods: This study was conducted as prospective, randomized and controlled.120 patients of either sex, ASA grade I and II and aged between 18 to 65 years were included in the study. These patients were randomly divided into 3 groups i.e. Group A (bolus), Group B (bolus + infusion) and Group C(control).General anaesthesia was administered to the patient and the study drug was administered to the patient 10 minutes before the skin incision. Intraoperative blood loss and blood transfusions were noted.Data has been analysed using SPSS (Statistical Packages for Social Sciences, version 21.0. Armonk, NY: IBM corp.) .

Results: The intra-operative blood loss was least in the Bolus group and was maximum in the placebo group. The use of TXA significantly reduced the transfusion requirements in major surgeries with the least amount of transfusion needed in the Infusion group.

Conclusion(s): The use of TXA ( in bolus as well as the infusion) led to statistically significant reduction in blood loss and the requirement of transfusion. We would suggest the use of TXA in bolus dose pre-operatively before a radical surgical procedure to minimize the intra-operative blood loss and the requirement of transfusion.