CC BY-NC-ND 4.0 · Journal of Neuroanaesthesiology and Critical Care 2019; 06(03): 257-266
DOI: 10.1055/s-0039-1693083
Review Article
Indian Society of Neuroanaesthesiology and Critical Care

Tranexamic Acid in Neuroanesthesia and Neurocritical Care: Time for Its Critical Appraisal

Bhavna Hooda
1  Department of Anaesthesiology and Critical Care, Army Hospital Research & Referral, New Delhi, India
Radhakrishnan Muthuchellappan
2  Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
› Author Affiliations
Further Information

Publication History

Received: 05 February 2019

Accepted after revision: 22 April 2019

Publication Date:
26 July 2019 (online)


There is a renewed interest in the use of antifibrinolytics, especially tranexamic acid (TxA), in varied clinical settings such as trauma, perioperative bleeding, cardiac surgery, and multilevel spine instrumentation procedures. Because of its prothrombotic potential, the use of TxA in neurosurgical disorders has not gained popularity since this subset of the population is more prone to developing thromboembolic complications. However, recent studies have shown that TxA reduces blood loss, reduces the need for allogeneic blood transfusion, and is associated with minimal side effects. In this narrative review, Google Scholar, PubMed, and EMBASE databases were searched to identify publications relevant to the current use of TxA in varied neurosurgical and critical care settings. These publications were analyzed, and a summary of the findings and the role of future research on this drug are presented in this review.