European Journal of Molecular & Clinical Medicine

Abstract

Background: Tranexamic acid (TXA) is a well-known antifibrinolytic drug that can be taken by mouth, injected into the muscle, or given through a vein. But there isn't much evidence that IV TXA helps reduce the need for blood transfusions during spinal surgery.
Method: We used electronic PubMed, Cochrane Central Register of Controlled Trials, and Embase databases to do a meta-analysis of randomized controlled trials (RCTs) and quasi-randomized trials (qi-RCTs) that included patients who had different spinal surgeries, such as adolescent scoliosis surgery given with perioperative IV TXA. Two independent researchers looked for more journal articles and conference proceedings by hand.
Results: There were a total of 9 studies, and 581 patients were used as samples. Mean blood loss was cut by 128.28 ml during surgery (range: 33.84-222.73 ml), 98.49 ml after surgery (range: 83.22–113.77 ml), and 389.21 ml all together in patients who were given perioperative IV TXA (ranging from 177.83 to 600.60 ml). The average amount of packed cells that were given as a transfusion was cut by 134.55 ml (range: 51.64-217.46 ml; 95% CI; P = 0.0001). Overall, 35% fewer patients treated with TXA needed blood transfusions than patients treated with the comparator (RR = 0.65; 95% CI = 0.53 to 0.85; P = 0.0001; I2 = 0%). It was seen that TXA had a positive effect and subgroup and sensitivity analyses confirmed this. Seven studies gave information about DVT. The study with only one DVT case was not added to the other ones.
Conclusions: With IV TXA treatment before and after spinal surgery, patients lost less blood. Also, there was a big drop in the number of spinal surgery patients who needed blood transfusions. Before TXA can be used safely on people having spine surgery, our findings need to be confirmed by more research.