The Efficacy and Safety of Topical Saline Irrigation with Tranexamic Acid on Perioperative Blood Loss in Patients Treated with Percutaneous Endoscopic Interlaminar Diskectomy: A Retrospective Study

Yu Zhang; Wenjie Zhao; Man Hu; Xin Liu; Qing Peng; Bo Meng; Sheng Yang; Xinmin Feng; Liang Zhang

doi:10.1055/s-0043-1769127

Journal of Neurological Surgery Part A: Central European Neurosurgery, Inhaltsverzeichnis

J Neurol Surg A Cent Eur Neurosurg 2024; 85(03): 280-287
DOI: 10.1055/s-0043-1769127

Original Article

The Efficacy and Safety of Topical Saline Irrigation with Tranexamic Acid on Perioperative Blood Loss in Patients Treated with Percutaneous Endoscopic Interlaminar Diskectomy: A Retrospective Study

Autoren

Yu Zhang ^*

¹Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
Wenjie Zhao^*

²Graduate School of Dalian Medical University, Dalian, China
Man Hu

²Graduate School of Dalian Medical University, Dalian, China
Xin Liu

¹Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
Qing Peng

¹Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
Bo Meng

²Graduate School of Dalian Medical University, Dalian, China
Sheng Yang

²Graduate School of Dalian Medical University, Dalian, China
Xinmin Feng

¹Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China
Liang Zhang

¹Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China

Abstract

Background Tranexamic acid (TXA) is safe and effective in preventing bleeding during spinal surgery. However, there is currently no relevant research on the efficacy and safety of adding TXA to the saline irrigation fluid in percutaneous endoscopic interlaminar diskectomy (PEID). This study aimed to evaluate the efficacy and safety of topical saline irrigation with TXA for PEID in the treatment of lumbar disk herniation.

Methods In this single-center, retrospective cohort study, patients who underwent PEID for L5–S1 lumbar disk herniation were included and allocated to two groups according to whether they had been administered TXA. PEID was performed with saline irrigation fluid containing 0.33 g of TXA per 1 L of saline in the TXA group (n = 38). In the control group (n = 51), the saline irrigation fluid was injected with the same volume of normal saline. All PEIDs were performed by the same spine surgery team. The hidden blood loss (HBL), intraoperative blood loss (IBL), total blood loss (TBL), amount of fluid used, operation time, visual clarity, hospital stay, blood transfusion rate, coagulation index, and complication rate were compared between the two groups.

Results The TBL, HBL, and IBL in the TXA group were significantly lower than those of the control group. The postoperative hemoglobin in the TXA group was significantly higher than that of the control group. Visual clarity was significantly better and the operation time was significantly shorter in the TXA group. However, there was no significant difference in postoperative hematocrit, blood coagulation function, amount of fluid used, blood transfusion rate, and perioperative complications between the two groups.

Conclusion In PEID, the addition of TXA to topical saline irrigating fluid can significantly reduce the HBL, IBL, and TBL. The addition of TXA to topical saline irrigating fluid can improve visual clarity in the surgery and reduce operation time, but it does not change the coagulation function or the complication rate.

Keywords

hidden blood loss - percutaneous endoscopic interlaminar diskectomy - tranexamic acid - topical - visual clarity

Volltext

Referenzen

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