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 study was to evaluate the effect of intravenous tranexamic acid (TXA) on the blood loss volume during surgery and surgeon's satisfaction in intertrochanteric fracture surgery.

Methods: A total of 62 patients with intertrochanteric fracture were involved in the study and accidentally categorized into two groups. In the control or first group, patients were medicated with placebo (age: 69.2 ± 6.1 years old) and in the second group or intervention, they received 1 g injection of TXA (age: 69.7 ± 6.4 years old). Intraoperative bleeding was measured by the amount of blood in the suction bottle and amount of gauze utilized and postoperative blood loss was measured by the amount of blood in the drain 48 hours after surgery. Also, hemoglobin (Hb) levels were compared before and after surgery. In the end, the surgeon’s satisfaction was measured by Likert scale.

Results: The difference in the amount of intra-operative bleeding was significant between the groups (P < 0.050). The mean number of utilized gauze in the intervention group was meaningfully less than the placebo group (P < 0.050). The mean Hb in the control group was considerably inferior to the intervention group (P < 0.050). The respect of patients in need of transfusion in the placebo group was outstandingly superior to the intervention group (P < 0.005). Surgeon satisfaction in the intervention group was considerably greater than the control group (P < 0.050).

Conclusion: The use of intravenous TXA during intertrochanteric fracture surgery can reduce hemorrhage during surgery, reduce the need for blood products, and finally improve the surgeon’s satisfaction.