A Single Preoperative Dose of Tranexamic Acid Reduces Periop
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Tranexamic acid is a synthetic antifibrinolytic that has been used in various surgical disciplines to reduce blood loss, blood transfusions, ecchymosis, and hematoma formation. However, there is no universal standard on the most effective dose and route of Tranexamic acid administration, limiting its routine use in many centers. This study evaluates the current evidence for the efficacy and safety of a single preoperative dose of Tranexamic acid on surgical blood loss in all surgical disciplines.

A total of 1906 articles were screened, 57 met inclusion criteria. The majority of included studies were orthopedic (27), followed by obstetric and gynecological (16), oral maxillofacial and otolaryngology (10), cardiac (3), and 1 plastic surgery study focusing on acute burn reconstruction. Across all surgical specialties, the perioperative estimated blood loss was lower in patients receiving Tranexamic acid, with a standard mean difference of -153.33 mL. Overall, surgical patients with Tranexamic acid had a 72% reduced odds of transfusion. The most frequently used dose of Tranexamic acid was 15 mg/kg. There was no difference in the incidence of venous thromboembolic events between Tranexamic acid and control groups.

While there is a growing body of evidence to support the benefits of perioperative Tranexamic acid use, this is the first meta-analysis to identify the efficacy and safety of a single preoperative dose of IV Tranexamic acid. The potential implications for expanding the use of preoperative Tranexamic acid for elective day surgery procedures are substantial. Preoperative intravenous Tranexamic acid reduced perioperative blood loss and transfusion requirements in a variety of surgical disciplines without increasing the risk of thromboembolic events. Therefore, it should be considered for prophylactic use in surgery to reduce operative bleeding.

Source:https://journals.lww.com/annalsofsurgery/Abstract/2021/01000/A_Single_Preoperative_Dose_of_Tranexamic_Acid.13.aspx
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