Tranexamic acid (TXA) is an antifibrinolytic drug that has the property to reduce intraoperative and postoperative bleeding. This study was intended to establish the effect of TXA in minimizing the intraoperative and postoperative blood loss in laparoscopic sleeve gastrectomy.
Materials and methods
This was a prospective follow-up study conducted in Sabah Hospital, Kuwait, over 4 months from September 2014 to December 2014. A total of 50 patients who underwent laparoscopic sleeve gastrectomy were included in this study; 25 patients were given tranexamic acid during induction and 25 did not receive. Selection of patients was done on a random basis. Intraoperative blood loss, visibility of field of surgery, and amount of blood collected in suction apparatus used during surgery.
Results
Each group consisted of 25 patients. Preoperative intravenous bolus administration of TXA at 10 mg/kg reduces blood loss.
Conclusion
Tranexamic acid is an antifibrinolytic agent that inhibits the action of plasmin. There is also reduction in blood level of D-dimer. It is seen to significantly reduce intraoperative blood loss during surgery. Additionally, there seems to be no alterations of coagulation parameters or untoward systemic effects. This should prompt further trials.
How to cite this article
Alhomoud H. The Effect of Tranexamic Acid on Blood Loss during Laparoscopic Sleeve Gastrectomy. World J Lap Surg 2016;9(1):30-33.
Haemostatic effect of tranexamic acid mouthwash in anticoagulant- treated patients undergoing oral surgery. N Engl J Med 1989 Mar 30;320(13):840-843.
Tranexamic acid as a mouthwash in anticoagulant-treated patients undergoing oral surgery: An alternative method to discontinuing anticoagulant therapy. Oral Surg Oral Med Oral Pathol 1993 Jan;75(1):29-31.
Prevention of postsurgical bleeding in oral surgery using tranexamic acid without dose modification of oral anticoagulants. J Oral Maxillofac Surg 1993 Nov;51(11):1211-1216.
Oral surgery in anticoagulated patients without reducing the dose of oral anticoagulant: a prospective randomized study. J Oral Maxillofac Surg 1996 Jan;54(1):27-32.
Use of tranexamic acid mouthwash to prevent post-operative bleeding in oral surgery patients on oral anticoagulant medication. Quintessence Int 1997 Jun;28(6):375-378.
Effect of local antifibrinolytic treatment with tranexamic acid in haemophiliac undergoing oral surgery. J Oral Maxillofac Surg 1986 Sep;44(9):703-707.
Pharmacological approaches to reducing allogenic blood exposure. Vox Sang 2003 Jan;84(1):2-10.
Tranexamic acid: a review of its use in surgery and other indications. Drugs 1999 Jun;57(6):1005-1032.
Evaluation of the efficacy of tranexamic acid on blood loss in orthognathic surgery: a prospective, randomized clinical study. Int J Oral Maxillofac Surg 2012 Jun;41(6):713-717.
Effects of topical antifibrinolytics in endoscopic sinus surgery: a pilot randomized controlled trial. Am J Rhinol 2007 Nov-Dec;21(6):737-742.
The effect of tranexamic acid on blood loss during orthognathic surgery: a randomised controlled trial. J Oral Maxillofac Surg 2009 Jan;67(1):125-133.
Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomized placebo-controlled trial. West Indian Med J 2010 Dec;59(6):612-624.
Effect of tranexamic acid in traumatic brain injury. A nested randomized, placebo controlled trial (CRASH-2 intracranial bleeding study). BMJ 2011;343:3795.
Evaluation of hemorrhage depressors on blood loss during orthognathic surgery: a retrospective study. J Oral Maxillofac Surg 2004 Jun;62(6):662-666.
Tranexamic acid reduces intraoperative blood loss in pediatric patients undergoing scoliosis surgery. Anesthesiology 2005 Apr;102(4):727-732.
The dose-response relationship of tranexamic acid. Anesthesiology 1995 Feb;82(2):383-392.
Pharmacokinetics of tranexamic acid after intravenous administration to normal volunteers. Eur J Clin Pharmacol 1974 Aug 23;7(5):375-380.
Pharmacokinetics and bioavailability of tranexamic acid. Eur J Clin Pharmacol 1981;20(1):65-72.
