Topical Tranexamic Acid Blunts Blood Loss After TKA

Pain Medicine News—October 13, 2014

A topical application of tranexamic acid (TXA) after surgery is a simple, effective way to reduce blood loss, transfusions and the risk for systemic side effects, researchers have found. Normally given orally or intravenously, TXA has been used successfully in a variety of surgeries to prevent the dissolution of blood clots, but some clinicians are still hesitant about administering the drug.

But Stavros G. Memtsoudis, MD, an attending anesthesiologist at the Hospital for Special Surgery, in New York City, said studies have shown—and some clinicians have bought into the idea—that TXA is effective in reducing blood transfusions, but the drug is not given to all patients due to safety issues.

“The big question, really, is why doesn’t everyone get it? And the answer to that would be because the safety data are still really difficult to come by. Because to determine safety, you require much bigger studies,” Dr. Memtsoudis said.

He said the Hospital for Special Surgery administers TXA topically and intravenously, and that topical use has become more popular in recent years because it is believed “to reduce the dosage that the patient gets exposed to systemically that could cause clotting compared with giving it through the IV.”

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