Effect of Tranexamic Acid On Intraoperative Blood Loss and Transfusion Requirements in Major Abdominal Surgeries.

Abstract

Background:Tranexamic acid (TXA) is an antifibrinolytic medication which prevents fibrinolysis, promotes clotting stability and lessens blood loss. Its application in significant abdominal surgeries has gained interest in the possibility of reducing the intraoperative bleeding and transfusion need. Its effectiveness in other abdominal surgical scenarios is, however, still being investigated and therefore needs further clinical evaluation.

Objectives:This paper assesses the efficacy of tranexamic acid in lessening intraoperative blood loss and the need for transfusion during significant abdominal operations and compares the outcomes of patients who use tranexamic acid with those of patients undergoing the procedure using a placebo.

Methodology: this prospective observational study  done on 100 patients who were undergoing major abdominal surgeries, colectomy, gastrectomy and hepatectomy. The participants were randomly assigned to receive 1 g of tranexamic acid intravenously or a placebo 30 minutes before surgery. The amount of intraoperative blood loss was measured, and the blood transfusions needed were calculated. SPSS version 26.0 was used to perform statistical analysis, and Chi-square tests were applied to categorical variables with independent t-tests on continuous variables. All the participants gave informed consent, and ethical approval was received.

Results: 100 patients, with a mean age of 58.2 ± 12.4 years. Of these, 50 received TXA, and 50 received a placebo. In the TXA group, the mean intraoperative blood loss was significantly lower at 250 mL (SD ± 70), compared to 450 mL (SD ± 100) in the placebo group (p < 0.001). The transfusion rate in the TXA group was reduced to 12%, while the placebo group required transfusions in 28% of cases (p = 0.03). The total amount of blood transfused was significantly lower in the TXA group (300 mL, SD ± 90) compared to the placebo group (600 mL, SD ± 150). No significant differences were found in the incidence of adverse events, including thromboembolic complications (p = 0.78).

Conclusion: Tranexamic acid plays a major part in reducing intraoperative blood loss and the need to transfuse in major abdominal surgeries. These results imply that TXA is an affordable and safe alternative to reduce bleeding in the operating room, to support the use of this agent in all patients, and to enhance patient outcomes. Nonetheless, its role in other surgical settings needs to be investigated in further large-scale studies, and its long-term effects on recovery and complications should be assessed.