Tranexamic Acid in Bolus vs. Infusion In Hip Arthroscopy; Bleeding Improvement as a Silent Complication

Abstract

Purpose: the present study examines the effects of tranexamic acid (TXA) on reducing blood loss during hip arthroscopy, comparing two different methods of administration (bolus vs. infusion).

Methods: a prospective study with 70 patients undergoing hip arthroscopy was carried out. The patients within the TXA infusion group (group A) received TXA in a loading dose of 2g 30 min before surgery intravenously followed by 10 mg/kg/h infusion (continued during the entire surgery); whereas group B received TXA as a 2-g intravenous bolus 30 min before surgery. Hemoglobin and hematocrit measures were evaluated before surgery and 24 hours after surgery. Statistically significant results were considered at a P-value less than 0.05, with a 95% confidence interval.

Results: Mean hemoglobin decrease 24 h after surgery was lower in patients of group A (1.18 +/-0.99 g/dL) than within group B (1.84+/-0.78 g/dL), statistically significant (p = 0.003). The mean hematocrit decrease 24 h postoperatively was lower in patients of group A than in group B (3.52+/-3.37 vs. 5.08+/-2,45), once more with significant results (p =0.002).

Conclusions: This prospective clinical study showed that the use of TXA in infusion slows down the hemoglobin and hematocrit loss with respect to the bolus TXA group with negligible side effects when the administration combined initial bolus and infusion perfusion during the surgery.