@article{10.11648/j.ijacm.20221001.12,
  author = {Asudo Felicia Dele and Okonkwo Azubuike Venatius and Isamade Erdoo Suckie and Abdullahi Ibrahim Habib},
  title = {Effect of Intravenous Tranexamic Acid as an Adjunct Haemostat with Pericervical Tourniquet on Perioperative Blood Loss Following Open Abdominal Myomectomy},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {10},
  number = {1},
  pages = {8-15},
  doi = {10.11648/j.ijacm.20221001.12},
  url = {https://doi.org/10.11648/j.ijacm.20221001.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20221001.12},
  abstract = {Uterine fibroid is a common gynaecological tumour. Abdominal myomectomy is a common surgical treatment for these women. Open abdominal Myomectomy is associated with significant risk of hemorrhage and the need for perioperative homologous blood transfusion with its potential risks, complications and cost. Tranexamic acid is a synthetic lysine derivative with antifibrinolytic activity used in other surgical disciplines to reduce blood loss during surgery. Its efficacy in reducing blood loss when used as an adjunct to pericervical tourniquet has not been elucidated. In a double blind, placebo-controlled trial, we assessed the effect of intravenous tranexamic acid as an adjunct haemostat with pericervical tourniquet on perioperative blood loss following open abdominal myomectomy in 132 ASA I-II women, aged 18–65 years, who had abdominal myomectomy. The patients were randomly allocated to receive either intravenous Tranexamic acid 1gm (n=66) or placebo (n=66) pre-operatively on arrival in theatre immediately after securing an IV access. All the patients also had a peri-cervical tourniquet applied intraoperatively to secure haemostasis. The volume of intraoperative blood loss, haemodynamic changes associated with blood loss and the complications associated with the use of tranexamic acid were evaluated during the first 72 hours following surgery. One hundred and thirty one (131) patients completed the study; Tranexamic acid group 66 and placebo group 65. One patient in the placebo group had uncontrollable postoperative haemorrhage. This necessitated her having total abdominal hysterectomy. She was thus disqualified from the study. Blood loss was significantly lower in the tranexamic acid group. Mean intraoperatively mean arterial pressure (MAP) compared to baseline was lower in the placebo while the mean intraoperative pulse rate compared to the baseline was higher in the placebo group. The only notable perioperative complication was nausea and vomiting. There was no difference in occurrence of complications between the groups. This study shows that intravenous tranexamic acid as an adjunct haemostat with pericervical tourniquet reduced blood loss, provide better haemodynamic stability with acceptable side effects during abdominal myomectomy.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Effect of Intravenous Tranexamic Acid as an Adjunct Haemostat with Pericervical Tourniquet on Perioperative Blood Loss Following Open Abdominal Myomectomy
AU  - Asudo Felicia Dele
AU  - Okonkwo Azubuike Venatius
AU  - Isamade Erdoo Suckie
AU  - Abdullahi Ibrahim Habib
Y1  - 2022/03/18
PY  - 2022
N1  - https://doi.org/10.11648/j.ijacm.20221001.12
DO  - 10.11648/j.ijacm.20221001.12
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 8
EP  - 15
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20221001.12
AB  - Uterine fibroid is a common gynaecological tumour. Abdominal myomectomy is a common surgical treatment for these women. Open abdominal Myomectomy is associated with significant risk of hemorrhage and the need for perioperative homologous blood transfusion with its potential risks, complications and cost. Tranexamic acid is a synthetic lysine derivative with antifibrinolytic activity used in other surgical disciplines to reduce blood loss during surgery. Its efficacy in reducing blood loss when used as an adjunct to pericervical tourniquet has not been elucidated. In a double blind, placebo-controlled trial, we assessed the effect of intravenous tranexamic acid as an adjunct haemostat with pericervical tourniquet on perioperative blood loss following open abdominal myomectomy in 132 ASA I-II women, aged 18–65 years, who had abdominal myomectomy. The patients were randomly allocated to receive either intravenous Tranexamic acid 1gm (n=66) or placebo (n=66) pre-operatively on arrival in theatre immediately after securing an IV access. All the patients also had a peri-cervical tourniquet applied intraoperatively to secure haemostasis. The volume of intraoperative blood loss, haemodynamic changes associated with blood loss and the complications associated with the use of tranexamic acid were evaluated during the first 72 hours following surgery. One hundred and thirty one (131) patients completed the study; Tranexamic acid group 66 and placebo group 65. One patient in the placebo group had uncontrollable postoperative haemorrhage. This necessitated her having total abdominal hysterectomy. She was thus disqualified from the study. Blood loss was significantly lower in the tranexamic acid group. Mean intraoperatively mean arterial pressure (MAP) compared to baseline was lower in the placebo while the mean intraoperative pulse rate compared to the baseline was higher in the placebo group. The only notable perioperative complication was nausea and vomiting. There was no difference in occurrence of complications between the groups. This study shows that intravenous tranexamic acid as an adjunct haemostat with pericervical tourniquet reduced blood loss, provide better haemodynamic stability with acceptable side effects during abdominal myomectomy.
VL  - 10
IS  - 1
ER  - 

Copy | Download