Introduction: The use of tranexamic acid in any form (intravenous, intra articular, oral) in total knee arthroplasty surgeries has been the subject of constant study. The different strategies to reduce bleeding are aimed at reducing the need for blood transfusion due to the risks involved. In our study we  established  the  use of  tranexamic  acid  in  reducing  peri operative  and  post operative  bleeding, the need for blood transfusion  and the  prevalence of  developing  postoperative  deep vein thrombosis in patients who had undergone  total knee replacement.

Materials and Methodology: 22 patients who underwent primary total knee arthroplasty from May 2016 to September 2018 were included in this study and are divided into two groups. 11 patients in one group received a single dose of 1 g of IV TXA (Group TXA) 10 mins before opening the pneumatic tourniquet. 11 patients in other group who didn’t receive IV TXA are termed as control group (Group C). Haemoglobin, the amount of blood loss and the number of blood transfusions were recorded and taken into account 24 hours after surgery. Deep vein thrombosis occurrence in patients post operatively was evaluvated during patient's stay in the hospital and 2 weeks and 1 month after surgery in review visits. This study is not a randomized study.

Results: Group TXA had less mean haemoglobin reduction post operatively compared to Group C(p=0.001). Blood loss following surgery was very much higher in Group C compared to group TXA (p=0.001). The total number of blood transfusions done post operatively was higher in Group C (p = 0.04). There were no occurrence of thrombo embolic events in this study.

Conclusion: Use of IV Tranexamic acid reduced postoperative bleeding without promoting thromboembolic events.

Keywords: Anaesthesia; Tranexamic acid; Total knee replacement; Bleeding; Blood transfusion

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Dr Piriyan T P

Post graduate, Department of Orthopaedics, Rajah Muthiah Medical College, Chidambaram