Perioperative Infusion of Tranexamic Acid Reduce the Risk of Hemorrhage
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on February 19th, 2025
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Bleeding is a significant concern in general surgery. When it occurs, it can complicate a patient’s recovery, extend their hospital stay, and sometimes necessitate additional operations to address the issue. Tranexamic acid, an antifibrinolytic agent, has been shown to effectively reduce hemorrhage risk in noncardiac surgeries. A study published in the Journal of the American Medical Association recently evaluated its use in general surgery.
The study involved 9535 participants, averaging 68.6 years of age, who were scheduled for noncardiac surgery. Colorectal operations were the most frequently performed procedures, followed by head and neck surgeries, upper gastrointestinal surgeries, and hepatopancreaticobiliary operations. These individuals were considered high risk for both hemorrhage and cardiovascular complications.
Patients were randomly assigned to receive an intravenous bolus of either a placebo or 1 gram of tranexamic acid at both the start and end of the operation. Tranexamic acid functions by blocking the conversion of plasminogen to plasmin, the enzyme responsible for breaking down fibrin and dissolving clots. After the operation, the patients were monitored for an additional 30 days. The researchers found that perioperative infusion of tranexamic acid reduced the risk of hemorrhage by 26%, with the most pronounced benefit observed among patients undergoing colorectal and hepatopancreaticobiliary surgeries.
The study involved 9535 participants, averaging 68.6 years of age, who were scheduled for noncardiac surgery. Colorectal operations were the most frequently performed procedures, followed by head and neck surgeries, upper gastrointestinal surgeries, and hepatopancreaticobiliary operations. These individuals were considered high risk for both hemorrhage and cardiovascular complications.
Patients were randomly assigned to receive an intravenous bolus of either a placebo or 1 gram of tranexamic acid at both the start and end of the operation. Tranexamic acid functions by blocking the conversion of plasminogen to plasmin, the enzyme responsible for breaking down fibrin and dissolving clots. After the operation, the patients were monitored for an additional 30 days. The researchers found that perioperative infusion of tranexamic acid reduced the risk of hemorrhage by 26%, with the most pronounced benefit observed among patients undergoing colorectal and hepatopancreaticobiliary surgeries.