Özgür ŞENTÜRK, Yeşim MACİT, Selçuk ŞİMŞEK, Faik Murat ÜNSAL, Mehmet Nurullah ERMİŞ, Can SOLAKOĞLU

Total kalça protezi yapilan bir Yehova Şahidi'nde traneksamik asidin kan kaybı üzerine etkisinin değerlendirilmesi Olgu sunumu

Traneksamik asidin total kalça ve diz protezlerinde kullanımı ile, kan kaybının ve allojenik kan transfüzyonu gereksiniminin azaldığı birçok çalışma ile gösterilmiştir. Dini inanış gereği allojenik ve otolog kan transfüzyonunu reddeden Yehova şahidinde traneksamik asidin peroperatif kanama üzerine etkileri değerlendirildi. 72 yaşında, ASA II Yehova şahidi olan hastaya sağ koksartroz nedeniyle total kalça protezi planlandı. Preoperatif değerlendirilmesinde Hb:13,3 mg/dl idi. Hasta allojenik ve otolog kan transfüzyonunu kabul etmediğini, ancak “cell saver” yöntemini kullanabileceğimizi bildirdi. Hastaya spinal anestezi uygulandı ve cell saver yöntemi kullanıma hazırlandı. Cerrahi ilk insizyondan yarım saat önce 10 mg/kg Traneksamik asid infüzyonu yapıldı. İlk dozdan 3 saat sonra 2 mg/kg traneksamik asid infüzyonu tekrarlandı.Total cerrahi süre 100 dk, total kanama miktarı 150 ml idi. Hastanın kan tranfüzyonuna gereksinimi olmadı. Postoperatif 5.gün taburcu edildi. İntraoperatif kullanılan traneksamik asidin total kalça artroplastisinde kan kaybını ve kan transfüzyon gereksinimini azalttığı görüldü.

Anahtar Kelimeler:

traneksamik asid, total kalça protezi, Yehova Şahidi

The evaluation of blood loss after tranexamic acid application in a Jehovah's Witness undergoing hip replacement surgery: Case report

There are several studies showing that tranexamic acid has been used effectively in total hip replacement surgery and knee arthroplasty in order to decrease blood loss and the need for allogenic blood transfusion. In this report we evaluated the effect of tranexamic acid on perioperative bleeding in a Jehovah's Witness who rejects allogeneic and autologous blood transfusion due to her religious beliefs. A 72-year-old, ASA II, female Jehovah's Witness was planned to undergo total hip replacement surgery due to right coxarthrosis. In the preoperative evaluation Hb was 13.3 mg/dl. The patient stated that she does not accept the allogeneic and autologous blood transfusion, but only did not reject the usage of the cell saver method. Patient underwent spinal anesthesia and cell saver method was prepared for use. Tranexamic acid at a dose of 10 mg/ kg was administered in 100 ml saline as 30 minute infusion, just before the first surgical incision. Three hours after the initial dose, tranexamic acid infusion was repeated at a dose of 2 mg/kg. Total surgical time was 100 minutes and total blood loss was 150 mL. The patient did not require blood transfusion. He was discharged on the 5th day postoperatively. Intraoperatively used tranexamic acid was found to reduce blood loss and blood transfusion requirements, in total hip replacement surgery.

Keywords:

Tranexamic acid, total hip arthroplasty, Jehovah's Witness,

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