TRANEXAMIC ACID (CYKLOKAPRON) REDUCES PERIOPERATIVE BLOOD-LOSS ASSOCIATED WITH TOTAL KNEE ARTHROPLASTY

In this prospective, randomized, double-blind study, we have investiga ted the effect of an antifibrinolytic agent, tranexamic acid (Cyklokap ron), on blood loss and transfusion requirements associated with total knee arthroplasty. Twenty-nine patients were allocated randomly to re ceive either tranexamic acid 15 mg kg(-1) or an equal volume of placeb o a few minutes before a tourniquet was deflated. Blood loss during su rgery, in the recovery room and on the surgical ward was recorded, tog ether with the number of units of blood transfused in hospital. Mean b lood loss during surgery was 428 (so 254) mi in the tranexamic acid gr oup (n = 15) compared with 415 (244) mi in the placebo group (n = 13). In the recovery room the tranexamic acid group lost 127 (95) mi and t he placebo group 576 (245) mi (P < 0.001). On the ward the respective volumes were 293 (200) mi and 558 (293) mi (P < 0.01). Total blood los s was 847 (356) mi in the tranexamic acid group and 1549 (574) mi in t he placebo group (P < 0.001). During the hospital stay the treatment g roup received 1.5 (1.3) units of blood compared with 3.3 (1.8) in the control group (P < 0.005). Two patients in the placebo group experienc ed a thrombotic complication compared with none in the treatment group . We conclude that tranexamic acid reduced perioperative blood loss an d transfusion requirements associated with total knee arthroplasty.