Use of Tranexamic acid is a cost effective method in preventing blood loss during and after total knee replacement
Sanjay Meena, JPN apex trauma centre , New delhi , India
10 January 2012
Sir,
I read with interest the article, Use of Tranexamic acid is a cost effective method in preventing blood loss during and after total knee replacement. However , I have some comments for authors and readers:
(1) Intra operative blood loss was not taken in account. So exact amount of blood loss couldn¿t be determined.
(2) Some studies [1] have demonstrated a minimum dosage of 10 mg / kg of TEA, to obtain the desired antihemorrhagic effect. Hence, the authors may have started with lesser amount of dosage so as to minimize the side effects.
(3) Single dose of TEA has also been shown to be equally efficient in controlling blood loss during TKA [2]
(4) Since the mean duration of effect of TXA is around 3 hours a second dose may be administered after this period to prolong the effect over the first 6 h, when most bleeding occurs.[3]
Refrences:
1. Kinzel V, Shakespeare D, Derbyshire D. The effect of aprotinin on blood loss in bilateral total knee arthroplasty. Knee 2005;12:107-11.
2. Ralley FE, Berta D, Binns V, Howard J, Naudie DD. One intraoperative dose of TA for patients having primary hip or knee arthroplasty. Clin Orthop Relat Res. 2010;468:1905-11.
3. M. A. Camarasa1, G. Olle´1, M. Serra-Prat, A. Mart¿´n1, M. Sa´nchez1, P. Rico´s1, A. Pe´rez1 and L. Opisso1. Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: a randomized clinical trial British Journal of Anaesthesia 96 (5): 576¿82 (2006)
Journal of Orthopaedic Surgery and Research
Use of Tranexamic acid is a cost effective method in preventing blood loss during and after total knee replacement
10 January 2012
Sir,
I read with interest the article, Use of Tranexamic acid is a cost effective method in preventing blood loss during and after total knee replacement. However , I have some comments for authors and readers:
(1) Intra operative blood loss was not taken in account. So exact amount of blood loss couldn¿t be determined.
(2) Some studies [1] have demonstrated a minimum dosage of 10 mg / kg of TEA, to obtain the desired antihemorrhagic effect. Hence, the authors may have started with lesser amount of dosage so as to minimize the side effects.
(3) Single dose of TEA has also been shown to be equally efficient in controlling blood loss during TKA [2]
(4) Since the mean duration of effect of TXA is around 3 hours a second dose may be administered after this period to prolong the effect over the first 6 h, when most bleeding occurs.[3]
Refrences:
1. Kinzel V, Shakespeare D, Derbyshire D. The effect of aprotinin on blood loss in bilateral total knee arthroplasty. Knee 2005;12:107-11.
2. Ralley FE, Berta D, Binns V, Howard J, Naudie DD. One intraoperative dose of TA for patients having primary hip or knee arthroplasty. Clin Orthop Relat Res. 2010;468:1905-11.
3. M. A. Camarasa1, G. Olle´1, M. Serra-Prat, A. Mart¿´n1, M. Sa´nchez1, P. Rico´s1, A. Pe´rez1 and L. Opisso1. Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: a randomized clinical trial British Journal of Anaesthesia 96 (5): 576¿82 (2006)
Competing interests
none