Abstract: Introduction: Femoral neck fractures are frequent injuries in a trauma centre and have a high incidence in the general population. Hip fracture surgeries are associated with substantial blood loss, exposing patients to postoperative anaemia. The severity of anaemia is related directly to post-operative functional recovery of the patients, which is related to long-term mortality. Blood transfusion related adverse effects also can directly influence the recovery. Tranexamic acid is a simple and inexpensive synthetic antifibrinolytic agent, which prevents the degradation of fibrin and delays the breakdown of haemostasis clots. Aim of this study is to assess the efficacy of intra-venous administration of Tranexamic acid in patients undergoing hemiarthroplasty with regards to blood loss at perioperative period.
Materials and Methods: A prospective randomised control study was done in a tertiary care hospital in southern part of India during the period of January 2016 to June 2017. 40 consecutive fracture neck of femur patients were randomised into two group, each group consist of 20 patient, Group 1 patients received placebo of 50 ml of normal saline administered intravenously 10 minutes before starting the surgery. Group 2 patients received Tranexamic acid -1500Mg diluted in 50ml Normal Saline administered intravenously 10 minutes before the surgery. Intraoperative blood loss was assessed by collecting the number of fully soaked mopping pads, fully soaked gauze pieces and quantity of irrigation fluid form suction bottle after subtracting the amount of normal saline used for wash. Post operatively all patients were assessed by evaluating the haemoglobin, Packed cell volume values from patients and blood collected in the negative suction drain of day 1 and day 2. The study group and control group parameters were analysed and compared.
Results: 45 patients were enrolled in our study and 5 patients were excluded from the study due to not giving consent for study. Demographic date like age, gender, side of fracture, type of fracture type of prosthesis were not influenced our study. Requirement of intra operative blood transfusion were significantly reduced in study group in comparison with control group which was statistically significant (p=0.027). In study group only 3 patient received blood transfusion, whereas control group 11 patents were received.
Conclusion: In our study, there was significant reduction in the amount of blood loss in tranexamic acid administered group when compared to the placebo group. Tranexamic acid was cost effective and safer when compared to blood components. Tranexamic acid should be considered for routine use in Hemiarthroplasty surgery to decrease blood loss.
