Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Kulkarni, Atul P, Chaukar, Devendra A, Patil, Vijaya P, Metgudmath, Rajendra B, Hawaldar, Rohini W, Divatia, Jigeeshu V
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782418/
https://www.ncbi.nlm.nih.gov/pubmed/26962250
http://dx.doi.org/10.4103/0019-5049.174798
_version_ 1782419952025731072
author Kulkarni, Atul P
Chaukar, Devendra A
Patil, Vijaya P
Metgudmath, Rajendra B
Hawaldar, Rohini W
Divatia, Jigeeshu V
author_facet Kulkarni, Atul P
Chaukar, Devendra A
Patil, Vijaya P
Metgudmath, Rajendra B
Hawaldar, Rohini W
Divatia, Jigeeshu V
author_sort Kulkarni, Atul P
collection PubMed
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.
format Online
Article
Text
id pubmed-4782418
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-47824182016-03-09 Does tranexamic acid reduce blood loss during head and neck cancer surgery? Kulkarni, Atul P Chaukar, Devendra A Patil, Vijaya P Metgudmath, Rajendra B Hawaldar, Rohini W Divatia, Jigeeshu V Indian J Anaesth Original Article 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. Medknow Publications & Media Pvt Ltd 2016-01 /pmc/articles/PMC4782418/ /pubmed/26962250 http://dx.doi.org/10.4103/0019-5049.174798 Text en Copyright: © Indian Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kulkarni, Atul P
Chaukar, Devendra A
Patil, Vijaya P
Metgudmath, Rajendra B
Hawaldar, Rohini W
Divatia, Jigeeshu V
Does tranexamic acid reduce blood loss during head and neck cancer surgery?
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 Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782418/
https://www.ncbi.nlm.nih.gov/pubmed/26962250
http://dx.doi.org/10.4103/0019-5049.174798
work_keys_str_mv AT kulkarniatulp doestranexamicacidreducebloodlossduringheadandneckcancersurgery
AT chaukardevendraa doestranexamicacidreducebloodlossduringheadandneckcancersurgery
AT patilvijayap doestranexamicacidreducebloodlossduringheadandneckcancersurgery
AT metgudmathrajendrab doestranexamicacidreducebloodlossduringheadandneckcancersurgery
AT hawaldarrohiniw doestranexamicacidreducebloodlossduringheadandneckcancersurgery
AT divatiajigeeshuv doestranexamicacidreducebloodlossduringheadandneckcancersurgery