Efficacy of oral Tranexamic Acid in reducing blood loss during primary total hip arthroplasty: A comparative study

Essien UE; Inyang UC; Itakpe SE; Lawal WO; Dim EM; Usendiah IB

doi:10.61386/imj.v16i2.311

Authors

Essien UE Department of Orthopaedic and Traumatology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
Inyang UC Department of Orthopaedic and Traumatology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
Itakpe SE National Orthopaedic Hospital, Igbobi, Lagos State, Nigeria
Lawal WO National Orthopaedic Hospital, Igbobi, Lagos State, Nigeria
Dim EM Department of Orthopaedic and Traumatology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
Usendiah IB Department of Orthopaedic and Traumatology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria

DOI:

https://doi.org/10.61386/imj.v16i2.311

Keywords:

Oral tranexamic acid, Intravenous tranexamic acid, Total hip arthroplasty, Perioperative blood loss

Abstract

Background: Perioperative blood loss is a major concern for patients undergoing total hip arthroplasty. Intravenous Tranexamic acid is commonly used to reduce blood loss and need for blood transfusion following total hip replacement. Recent studies have shown the efficacy of oral tranexamic acid in reducing perioperative blood loss in total hip replacement.

Method: A total of 69 patients undergoing primary total hip replacement in National Orthopaedic Hospital, Igbobi, Lagos, were recruited. Patients were randomized to receive 2gram oral tranexamic acid 2hours before incision or 1-gram intravenous tranexamic acid 10minutes before incision. Primary outcome measure was reduction in haemoglobin concentration.

Results: There was no significant difference in mean reduction in haemoglobin concentration in the oral tranexamic acid group compared to intravenous tranexamic acid group (3.78g/dl ±1.27 and 3.61g/dl ±0.54 respectively, P- 0.49). There was no significant difference between total blood loss and requirement for blood transfusion in the two groups.

Conclusion: Oral and intravenous routes of tranexamic acid administration have comparable efficacy in reducing blood loss and requirement for blood transfusion. Oral tranexamic acid is cheaper, easier to administer and should be considered as a safe and effective alternative to intravenous tranexamic acid.