Adem Çöbden, Hüseyin Demirel, Halil Gök, Mehmet Kış, Yalkın Çamurcu, Hanifi Üçpunar

Eşzamanlı bilateral total diz artroplastisi uygulanan hipertansiyonlu hastalarda intra-artiküler tranexamik asit etkinliğinin değerlendirilmesi

Amaç: Total diz artroplastisi (TDA) uygulanan hastalarda hipertansiyon (HT) ile artmış perioperatif transfüzyon oranı arasındaki ilişki literatürde daha önce araştırılmıştır. Bu durum aynı zamanda traneksamik asit (TXA) kullanmasına rağmen eşzamanlı bilateral TKA uygulanan hastalarda kan nakli ihtiyacını da artırabilir. Bu çalışmanın temel amacı, TXA'nın intraartiküler (İA) uygulanmasından sonra eşzamanlı bilateral TDA yapılan HT tanılı hastalarda, TXA almayanlara kıyasla, hemoglobin düzeylerinde azalma ve kan transfüzyonu ihtiyacını değerlendirmektir. Yöntem: Bu retrospektif çalışmada, eşzamanlı bilateral TDA uygulanan ve kriterlere uyan HT tanılı 191 hasta değerlendirildi. Hastalar TXA grubu (IA TXA alanlar) ve kontrol grubu (TXA almayanlar) olarak gruplandırıldı. Temel sonuç olarak belirleyiciler, hemoglobin düzeyleri ve kan transfüzyonu ünite sayısında azalma idi. Bulgular: Her iki grup yaş, cinsiyet, vücut kitle indeksi ve Amerikan Anesteziyoloji Derneği (ASA) skoru bakımından benzerdi ve istatistiksel olarak anlamlı bir farklılık gözlenmedi. Hemoglobin düzeylerinde (P = 0.844) azalma ve kan transfüzyonu ünite sayısı (P = 0.095) açısından gruplar arasında istatistiksel olarak anlamlı fark yoktu. Sonuç: Bulgularımıza göre, eşzamanlı bilateral TKA prosedürü uygulanan HT tanılı hastalarda, IA TXA alan ve almayan hastalar arasında hemoglobin seviyesinin azalması ve kan transfüzyonu ünite sayısı arasında istatistiksel olarak anlamlı fark bulunamamıştır.

Evaluation of the efficacy of intra-articular tranexamic acid in patients with hypertension undergoing simultaneous bilateral total knee arthroplasty

Objective: The relationship between hypertension (HT) and increased perioperative transfusion rate in patients whounderwent total knee arthroplasty (TKA) was previously investigated in the literature. This phenomenon may alsoincrease the need for blood transfusion in patients who underwent bilateral simultaneous TKA despite using tranexamicacid (TXA). The main purpose of this study was to evaluate the decrease in hemoglobin levels and need for bloodtransfusion in patients with the diagnosis of HT who underwent bilateral simultaneous TKA after intra-articular (IA)administration of TXA in comparison to those who did not receive TXA.Method: One hundred and ninety-one patients with the diagnosis of HT who underwent bilateral simultaneous TKA andfulfilled the criteria, were evaluated in this retrospective study. Patients were grouped as TXA group (individuals whoreceived IA TXA) and control group (did not receive TXA). Primary outcome measures were decrease in hemoglobinlevels and number of blood units transfused.Results: Both groups were similar in age, gender, body mass index and American Society of Anesthesiologist (ASA)score and no statistically significant differences were observed. There was also no statistically significant differencebetween groups in terms of decrease in hemoglobin levels (P=0.844) and number of blood units transfused (P=0.095).Conclusions: According to our results, in patients with the diagnosis of HT undergoing simultaneous bilateral TKAprocedure, no significant difference was observed in the decrease of hemoglobin level and number of blood unitstransfused between patients who received IA TXA in comparison to those who did not receive TXA.

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