Does tranexamic acid reduce blood loss during head and neck cancer surgery?
Background and Aims: Transfusion of blood and blood products poses several hazards. Antifibrinolytic agents are used to reduce perioperative blood loss. We decided to assess the effect of tranexamic acid (TA) on blood loss and the need for transfusion in head and neck cancer surgery. Methods: After...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2016;volume=60;issue=1;spage=19;epage=24;aulast=Kulkarni |
| _version_ | 1828761319629651968 |
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| author | Atul P Kulkarni Devendra A Chaukar Vijaya P Patil Rajendra B Metgudmath Rohini W Hawaldar Jigeeshu V Divatia |
| author_facet | Atul P Kulkarni Devendra A Chaukar Vijaya P Patil Rajendra B Metgudmath Rohini W Hawaldar Jigeeshu V Divatia |
| author_sort | Atul P Kulkarni |
| collection | DOAJ |
| description | Background and Aims: Transfusion of blood and blood products poses several hazards. Antifibrinolytic agents are used to reduce perioperative blood loss. We decided to assess the effect of tranexamic acid (TA) on blood loss and the need for transfusion in head and neck cancer surgery. Methods: After Institutional Review Board approval, 240 patients undergoing supramajor head and neck cancer surgeries were prospectively randomised to either TA (10 mg/kg) group or placebo (P) group. After induction, the drug was infused by the anaesthesiologist, who was blinded to allocation, over 20 min. The dose was repeated every 3 h. Perioperative (up to 24 h) blood loss, need for transfusion and fluid therapy was recorded. Thromboelastography (TEG) was performed at fixed intervals in the first 100 patients. Patients were watched for post-operative complications. Results: Two hundred and nineteen records were evaluable. We found no difference in intraoperative blood loss (TA - 750 [600–1000] ml vs. P - 780 [150–2600] ml, P = 0.22). Post-operative blood loss was significantly more in the placebo group at 24 h (P - 200 [120–250] ml vs. TA - 250 [50–1050] ml, P = 0.009), but this did not result in higher number of patients needing transfusions (TA - 22/108 and P - 27/111 patients, P = 0.51). TEG revealed faster clot formation and minimal fibrinolysis. Two patients died of causes unrelated to study drug. Incidence of wound complications and deep venous thrombosis was similar. Conclusion: In head and neck cancer surgery, TA did not reduce intraoperative blood loss or need for transfusions. Perioperative TEG variables were similar. This may be attributed to pre-existing hypercoagulable state and minimal fibrinolysis in cancer patients. |
| first_indexed | 2024-12-11T01:27:44Z |
| format | Article |
| id | doaj.art-fb7bf95ac15f4abcb0b45e05db05d080 |
| institution | Directory Open Access Journal |
| issn | 0019-5049 |
| language | English |
| last_indexed | 2024-12-11T01:27:44Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-fb7bf95ac15f4abcb0b45e05db05d0802022-12-22T01:25:27ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50492016-01-01601192410.4103/0019-5049.174798Does tranexamic acid reduce blood loss during head and neck cancer surgery?Atul P KulkarniDevendra A ChaukarVijaya P PatilRajendra B MetgudmathRohini W HawaldarJigeeshu V DivatiaBackground and Aims: Transfusion of blood and blood products poses several hazards. Antifibrinolytic agents are used to reduce perioperative blood loss. We decided to assess the effect of tranexamic acid (TA) on blood loss and the need for transfusion in head and neck cancer surgery. Methods: After Institutional Review Board approval, 240 patients undergoing supramajor head and neck cancer surgeries were prospectively randomised to either TA (10 mg/kg) group or placebo (P) group. After induction, the drug was infused by the anaesthesiologist, who was blinded to allocation, over 20 min. The dose was repeated every 3 h. Perioperative (up to 24 h) blood loss, need for transfusion and fluid therapy was recorded. Thromboelastography (TEG) was performed at fixed intervals in the first 100 patients. Patients were watched for post-operative complications. Results: Two hundred and nineteen records were evaluable. We found no difference in intraoperative blood loss (TA - 750 [600–1000] ml vs. P - 780 [150–2600] ml, P = 0.22). Post-operative blood loss was significantly more in the placebo group at 24 h (P - 200 [120–250] ml vs. TA - 250 [50–1050] ml, P = 0.009), but this did not result in higher number of patients needing transfusions (TA - 22/108 and P - 27/111 patients, P = 0.51). TEG revealed faster clot formation and minimal fibrinolysis. Two patients died of causes unrelated to study drug. Incidence of wound complications and deep venous thrombosis was similar. Conclusion: In head and neck cancer surgery, TA did not reduce intraoperative blood loss or need for transfusions. Perioperative TEG variables were similar. This may be attributed to pre-existing hypercoagulable state and minimal fibrinolysis in cancer patients.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2016;volume=60;issue=1;spage=19;epage=24;aulast=KulkarniBlood transfusion, cancer surgery, hypercoagulability, tranexamic acid |
| spellingShingle | Atul P Kulkarni Devendra A Chaukar Vijaya P Patil Rajendra B Metgudmath Rohini W Hawaldar Jigeeshu V Divatia Does tranexamic acid reduce blood loss during head and neck cancer surgery? Indian Journal of Anaesthesia Blood transfusion, cancer surgery, hypercoagulability, tranexamic acid |
| title | Does tranexamic acid reduce blood loss during head and neck cancer surgery? |
| title_full | Does tranexamic acid reduce blood loss during head and neck cancer surgery? |
| title_fullStr | Does tranexamic acid reduce blood loss during head and neck cancer surgery? |
| title_full_unstemmed | Does tranexamic acid reduce blood loss during head and neck cancer surgery? |
| title_short | Does tranexamic acid reduce blood loss during head and neck cancer surgery? |
| title_sort | does tranexamic acid reduce blood loss during head and neck cancer surgery |
| topic | Blood transfusion, cancer surgery, hypercoagulability, tranexamic acid |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2016;volume=60;issue=1;spage=19;epage=24;aulast=Kulkarni |
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