The efficacy and safety of multiple-dose oral tranexamic acid on blood loss following total hip arthroplasty: a randomized controlled trial

摘要

PurposesTo explore the efficacy and safety of multiple-dose oral tranexamic acid (TXA) on blood loss following primary total hip arthroplasty (THA).MethodsA total of 152 patients were randomized into three groups to receive 2g of oral TXA two hours pre-operatively (group A), or another bolus of 2g of oral TXA four hours post-operatively (group B), or another three boluses of 2g of oral TXA four, ten, and 16 hours post-operatively (group C). The primary outcomes were total blood loss (TBL), hidden blood loss (HBL), and transfusion rate. The secondary outcomes were haemoglobin (Hb) and haematocrit (Hct) drop, the level of fibrinolysis parameters (fibrin degradation products, D-dimer), and complications (thrombotic diseases, stroke, cardiac infarction, and infection).ResultsThe mean TBL and HBL in group C were lower than those in group A (p 0.05).ConclusionsMultiple boluses of oral TXA could further reduce blood loss, Hb and Hct drop, and restrain post-operative fibrinolysis in primary THA without increasing the risk of complications.Level of Evidence ITherapeutic study.