Safety and efficacy of epsilon aminocaproic acid (EACA) as an antihemorrhagic drug in bilateral one stage total knee arthroplasty: A double-blind randomized controlled trial.
Knee
; 27(1): 229-234, 2020 Jan.
Article
en En
| MEDLINE
| ID: mdl-31882387
ABSTRACT
BACKGROUND:
Antifibrinolytic drugs are widely used to minimize blood loss and transfusion requirements in total knee arthroplasty (TKA). Although tranexamic acid (TXA) has been widely studied for its use in TKA, there are limited studies on epsilon-aminocaproic acid (EACA).METHODS:
In a double-blind randomized control trial, all patients (nâ¯=â¯91) operated with bilateral simultaneous TKA were randomly given either intravenous EACA or placebo (normal saline). A single surgeon performed the TKA with posterior-stabilized implants under tourniquet. A suction drain was placed and kept for 48â¯h postoperatively. The intraoperative blood loss and drain output were calculated. The postoperative hemoglobin (Hb), drop in Hb, total blood loss, and number of blood transfusions in each group were calculated.RESULTS:
Both of the groups were comparable in terms of age, sex, body mass index, and pre-operative Hb. There was a significant difference between the EACA group and control group in terms of intraoperative blood loss (150â¯ml vs. 165â¯ml, Pâ¯=â¯0.01), drain output (494â¯ml vs. 1062â¯ml, Pâ¯<â¯0.001), postoperative Hb (9.9â¯g/dl vs. 8.6â¯g/dl, Pâ¯=â¯0.002), drop in Hb (2.2â¯g/dl vs. 3.1â¯g/dl, Pâ¯=â¯0.026) and transfusion rate (median transfusion 0 vs. 1, Pâ¯<â¯0.001). The total blood loss, as calculated by the Hb balance method, was significantly less (Pâ¯<â¯0.001) in the EACA group (0.99â¯l) compared with the control group (2.71â¯l). None of the patients developed any adverse reaction/complication to the drug.CONCLUSION:
Intraoperative administration of EACA significantly decreased the blood loss and postoperative transfusion rates compared with no antifibrinolytic therapy in bilateral simultaneous TKA.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Hemostáticos
/
Pérdida de Sangre Quirúrgica
/
Hemorragia Posoperatoria
/
Artroplastia de Reemplazo de Rodilla
/
Ácido Aminocaproico
/
Antifibrinolíticos
Tipo de estudio:
Clinical_trials
/
Etiology_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Knee
Asunto de la revista:
ORTOPEDIA
Año:
2020
Tipo del documento:
Article