A randomized prospective study of efficacy of Tranexamic Acid on Perioperative Blood Loss in Thoracic Spine Fixation

Background: Spine surgery is associated with significant blood loss, often requiring blood transfusion. The objective of this double blind study was to evaluate the efficacy of tranexamic acid (TXA) on perioperative blood loss in patients undergoing thoracic spine fixation.

 Materials and Methods: Sixty adult patients were randomized into two groups of 30 each. Group I received a bolus of 15 mg/kg i.v. of TXA after induction followed by a maintenance infusion of 1 mg/kg/hr up to closure of skin and Group II received an equivalent volume of normal saline after induction followed by a maintenance infusion up to closure of skin. Outcome measures included perioperative blood loss, amount of blood transfusion, postoperative haemoglobin and haematocrit levels.

Results: The mean perioperative blood loss was less in the TXA group compared to the placebo group (p value<0.05). The PRBCs transfusion was lower in the TXA group compared to the placebo group but there was no statistically significant difference between the two groups. The post-operative haemoglobin level was lower in the control group as compared to TXA group (p value <0.05).

Conclusion: TXA is effective in reducing peri-operative blood loss and blood transfusion.