Total kalça protezi ameliyatlarında traneksamik asit uygulamasının kanama ve kan transfüzyonu üzerine etkinliğinin değerlendirilmesi
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Tarih
2020
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Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada; total kalça protezi ameliyatı planlanan hastalarda insizyondan önce uygulanacak olan traneksamik asitin (TA) kanama, kan transfüzyonu, fibrin yıkım ürünleri ve böbrek fonksiyonları üzerine etkisini araştırmayı amaçladık. Yöntem: Etik kurul onayı alındıktan sonra, total kalça protezi ameliyatı geçirecek olan ASA I-III, 18-75 yaş arası 90 hasta çalışmaya dahil edildi. Çalışma randomize ve çift kör olacak şekilde yürütüldü. Operasyon öncesi hastalardan hemoglobin (Hgb), hematokrit (Hct), trombosit sayısı (Plt), INR, aktive edilmiş parsiyel tromboplastin zaman (aPTT), fibrinojen, D-dimer, kan üre azotu (BUN), kreatinin çalışıldı. Fasya iliaka kompartman bloğu (FİKB) ve spinal anestezi uygulandı. Cerrahi başlamadan önce Grup 1'e 30 mg/kg (max 2,5 g) TA verilirken Grup 2'ye 15 mg/kg (max 1,2 g) dozunda verildi. İntraoperatif ve postoperatif kanama miktarı kaydedildi. İntraoperatif ve postoperatif verilen kan ürünleri kaydedildi. Postoperatif 0., 1., 2. ve 6. saatlerde hastalardan tekrar kan örnekleri alındı. Bulgular: Demografik veriler, intraoperatif ve postoperatif kan transfüzyonu, Hgb, Hct, Plt, fibrinojen, D-dimer, kreatinin, BUN bakımından gruplar arasında fark yoktu. Grup 2'deki INR sonucu diğer gruba göre daha yüksek iken Grup 1 hastalarında aPTT 6. saatte daha yüksek bulundu. Grupiçi istatistiklere göre, her iki grupta da postoperatif 6. saatteki Hgb, Hct ve Plt değerleri preoperatif değerlere göre istatistiksel olarak daha düşük tespit edildi. Grup 1'in postoperatif 6. saateki; INR ve aPTT değerleri preoperatif değerlere göre istatiksel olarak anlamlı derecede daha yüksek tespit edildi. Grup 2'nin postoperatif 6. saateki; INR değeri preoperatife göre istatiksel olarak anlamlı derecede daha yüksek tespit edildi. Sonuç: Kalça protezi cerrahisinde kanama kontrolü sağlamada etkin olan TA'nın preoperatif 15 mg/kg ve 30 mg/kg dozlarında kullanımı postoperatif 0., 1., 2. ve 6. saatlerdeki takiplerde kanama ve kan transfüzyonu miktarını her iki grupta benzer şekilde azaltmıştır.
Background and aim: In this study, we aimed to investigate the effects of tranexamic acid administration before incision on bleeding, blood transfusion, fibrin degradation products and renal function in patients undergoing total hip arthroplasty. Methods: After obtaining ethical approval; ASA I-III, ninety patients aged between 18-75 years undergoing total hip arthroplasty were encluded to the study. The patients were randomly assigned. In all subjects, blood samples were taken before surgery in order to study Hgb, hct, platelet count, PT, PTT, fibrinogen, D-dimer, BUN, creatinine. Fascia iliac compartment block (FICB) and spinal anesthesia were applied to the patients. Group 1 was given 30 mg / kg (max 2.5 g) TA and Group 2 was given 15 mg / kg (max 1.2 g) before surgery. The amount of intraoperative and postoperative bleeding was recorded. Blood products given intraoperatively and postoperatively were recorded. Blood samples were taken again at 0th 1st, 2nd and 6th hours postoperatively. Results: There was no difference between the groups in terms of demographic, intra-operative and postoperative blood transfusion, Hgb, Hct, Plt, fibrinogen, D-dimer, creatinine, BUN. While the INR result in group 2 was higher than the other group, aPTT was higher in Group 1 patients at 6 hours. According to intragroup statistics, Hgb, Hct and Plt values at the 6th hour in both groups were statistically lower than the preoperative values. Group 1's postoperative 6th hour; INR and aPTT values were statistically significantly higher than preoperative values. Group 2 postoperative 6th hour; The INR value was statistically significantly higher than the preoperative. Conclusion: The use of TA, which is effective in providing bleeding control in hip replacement surgery, at the preoperative doses of 15 mg / kg and 30 mg / kg, decreased the amount of bleeding and blood transfusion similarly in both groups at postoperative 0, 1, 2 and 6 hours. Keyword: Hip replacement surgery, tranexamic acid, bleeding, blood transfusion
Background and aim: In this study, we aimed to investigate the effects of tranexamic acid administration before incision on bleeding, blood transfusion, fibrin degradation products and renal function in patients undergoing total hip arthroplasty. Methods: After obtaining ethical approval; ASA I-III, ninety patients aged between 18-75 years undergoing total hip arthroplasty were encluded to the study. The patients were randomly assigned. In all subjects, blood samples were taken before surgery in order to study Hgb, hct, platelet count, PT, PTT, fibrinogen, D-dimer, BUN, creatinine. Fascia iliac compartment block (FICB) and spinal anesthesia were applied to the patients. Group 1 was given 30 mg / kg (max 2.5 g) TA and Group 2 was given 15 mg / kg (max 1.2 g) before surgery. The amount of intraoperative and postoperative bleeding was recorded. Blood products given intraoperatively and postoperatively were recorded. Blood samples were taken again at 0th 1st, 2nd and 6th hours postoperatively. Results: There was no difference between the groups in terms of demographic, intra-operative and postoperative blood transfusion, Hgb, Hct, Plt, fibrinogen, D-dimer, creatinine, BUN. While the INR result in group 2 was higher than the other group, aPTT was higher in Group 1 patients at 6 hours. According to intragroup statistics, Hgb, Hct and Plt values at the 6th hour in both groups were statistically lower than the preoperative values. Group 1's postoperative 6th hour; INR and aPTT values were statistically significantly higher than preoperative values. Group 2 postoperative 6th hour; The INR value was statistically significantly higher than the preoperative. Conclusion: The use of TA, which is effective in providing bleeding control in hip replacement surgery, at the preoperative doses of 15 mg / kg and 30 mg / kg, decreased the amount of bleeding and blood transfusion similarly in both groups at postoperative 0, 1, 2 and 6 hours. Keyword: Hip replacement surgery, tranexamic acid, bleeding, blood transfusion
Açıklama
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation, Kalça protezi, traneksamik asit, kanama, kan transfüzyonu, Hip replacement surgery, tranexamic acid, bleeding, blood transfusion
