The Efficacy and Safety of Prophylactic Intravenous Tranexamic Acid on Perioperative Blood Loss in Patients Treated with Posterior Lumbar Interbody Fusion.

OBJECTIVE: To investigate the efficacy and safety of a prophylactic intravenous administration of tranexamic acid (TXA) 30 minutes before skin incision on perioperative blood loss in patients treated with posterior lumbar interbody fusion (PLIF).

METHODS: A total of 63 patients who underwent PLIF were recruited and divided into a TXA group (n = 26) and a control group (n = 37). Intraoperative blood loss, postoperative blood loss, duration of tube drainage, hospitalization time, blood transfusion rate, and incidence of complications were compared between the 2 groups.

RESULTS: There were no significant differences in the demographic characteristics and laboratory results between the 2 groups. The intraoperative blood loss, 24-hour postoperative drainage volume, 24-hour postoperative hidden blood loss, perioperative overt blood loss, hospitalization time, and postoperative duration of tube drainage were significantly reduced in the TXA group compared with the control group. In addition, the perioperative blood transfusion rate was lower in the TXA group (7.7%) than in the control group (16.22%), but the difference was not statistically significant. During a 3-month follow-up period, no pulmonary embolism, liver failure, or renal dysfunction was observed in the 2 groups. Likewise, the incidence of deep venous thrombosis was not found in the TXA group compared with 1 case in the control group, hence the difference was not statistically significant.

CONCLUSIONS: A prophylactic intravenous administration of TXA 30 minutes before skin incision effectively reduces the perioperative blood loss, duration of tube drainage, and hospitalization time, and it does not increase the risk of complications. However, TXA may not be able to decrease the rate of blood transfusion.