Introduction & Objective: Tranexamic acid is a synthetic antifibrinolytic drug that reduces bleeding
and transfusion requirements in cardiac surgery and total knee arthroplasty. In this study, we evaluated the
efficacy of the prophylactic tranexamic acid to reduce intraoperative bleeding and improving visual field of
the surgeon in patients undergoing lumbar hernial disc resection, anesthetize with two different methods of
inhalation or total intravenous anesthesia.
Materials & Methods: Eighty percent patients in ASA class I-II were randomized into 4 groups. In
group 1, anesthesia was achieved by total intravenous anesthesia and tranexamic acid was administered too.
Other groups were: group 2, anesthesia by total intravenous anesthesia without tranexamic acid, group 3,
anesthesia by halothane and tranexamic acid was administered and in group 4, anesthesia by halothane
without tranexamic acid was achieved. Blood loss and surgeon's satisfaction were registered.
Results: The amount of blood loss in each group was as follow:
Group 1: 267.1 ± 177.3 ml; group 2: 656 ± 411.6 ml
Group 3: 357 ± 307.2 ml; group 4: 550 ± 406.7 ml
The least bleeding was recorded in group 1 which had a significant difference with group 2 (p=0.007) and
group 4 (p=0.04) that tranexamic acid was not administered. Blood loss in group 2 and 4 was identical and
had no significant difference (p= 0.3). Surgeon's highest satisfaction was with group 1.
No complications were registered in 4 groups.
Conclusions: We concluded that administration of prophylactic tranexamic acid in patients undergoing
hernial disc resection has the potential to reduce intraoperative bleeding and improving visualization of the
surgical field especially when administered with total intravenous anesthesia. The method of anesthetic
management had no effect.