Tranexamic Acid Effectiveness on the Amount of Bleeding during Surgery and Surgeon’s Satisfaction in Intertrochanteric Fracture Fixation:A Randomized Clinical Trial

Abstract

Background: The purpose of this double-blind randomized clinical trial study was the evaluation of intravenous tranexamic acid on hemorrhage volume during Surgery and surgeon's satisfaction in intertrochanteric fracture surgery. Methods: A total of 62 intertrochanteric fractures (AO class 1 to 3) were randomly divided into two groups of 31. In the control group patients (69.2± 6.1 years old) treated with placebo and the intervention group receiving1gr tranexamic acid (69.7± 6.4) have exposed under the surgical operation by lateral approach and proximal femur’s plates., the amount of gauze and post operative blood losses measured with the amount of blood in the drain 48 hours after surgery. Also the hemoglobin levels compared before and after surgery. In the end, Surgeon satisfaction was measured by Likert scale. Results: The amount of intraoperative bleeding in suctiondid not differ statistically between the arms (P-value = 0.465).Furthermore, the mean of gauze number in the intervention group was significantly lower than the control group (P-value <0.05). although the mean amount of blood in the drain 48 hours after surgery in the control group was higher than the intervention group B, but it was not statistically significant (P-value = 0.05). The mean of hemoglobin in the control group was significantly lower than group B (P-value <0.05).the proportion of patients in need of transfusion in the control group was significantly higher than the intervention group (P-value <0.005). Mean of satisfaction in the intervention group was significantly higher than the other arm (P-value <0.05). Conclusion: The evaluation of intravenous tranexamic acid duringintertrochanteric fracture surgery can reduce hemorrhage volume during Surgery, reduce the need ofblood products’ transfusionand finally improve surgeon satisfaction.

Keywords

• Tranexamic Acid; Hip Fractures; Surgical Blood Loss; Randomized Controlled Trial