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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(03): 415-421
DOI: 10.1055/s-0041-1729933
Artigo Original

O papel do ácido tranexâmico na prevenção e gerenciamento da perda de sangue na artroplastia total de articulação[*]

Artikel in mehreren Sprachen: português | English
Adarsh Thammaiah 
1   Departamento de Ortopedia, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, Índia
,
Siddalingamurthy Gajapurada 
1   Departamento de Ortopedia, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, Índia
,
Sanjana Nandakumar 
1   Departamento de Ortopedia, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, Índia
,
Purushotham Sastry 
1   Departamento de Ortopedia, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, Índia
,
Mruthyunjaya Mruthyunjaya 
1   Departamento de Ortopedia, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, Índia
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Resumo

Objetivo Coletar dados sobre o papel desempenhado pelo ácido tranexâmico na prevenção e gerenciamento da perda de sangue em pacientes submetidos à artroplastia total do quadril (ATQ) e à artroplastia total do joelho (ATJ).

Métodos Neste estudo prospectivo e comparativo, 30 pacientes submetidos à ATQ ou à ATJ foram alocados aleatoriamente em 1 de 2 grupos com 15 pacientes. O ácido tranexâmico foi administrado por rotas intravenosas e tópicas no grupo de intervenção, mas não foi administrado no grupo controle. Foram observados parâmetros sanguíneos pré-operatórios, perda de sangue intra- e pós-operatória e necessidade de transfusão de sangue. A análise estatística foi realizada utilizando-se teste do qui-quadrado e o teste-t independente.

Resultados O grupo de intervenção apresentou hemoglobina mais elevada no pós-operatório de forma estatisticamente significante (p = 0,03), menor diferença entre concentração de hemoglobina pré- e pós-operatória (p = 0,046), menor diferença entre volume de células embaladas pré- e pós-operatório (p = 0,06), menor perda de sangue intraoperatória medida (p = 0,015) e menor volume de sangue coletado na drenagem (p = 0,0291) em comparação com o grupo controle. Também houve redução da frequência de transfusões de sangue no grupo de intervenção (p = 0,0008).

Conclusão O ácido tranexâmico está associado à redução da perda sanguínea intraoperatória e pós-operatória e à redução da frequência de transfusões de sangue em pacientes submetidos à ATQ/ATJ.

Palavras-chave

perda sanguínea cirúrgica - transfusão de sangue - artroplastia de quadril - joelho - ácido tranexâmico

* Trabalho desenvolvido no Departamento de Ortopedia, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, Índia.




Publikationsverlauf

Eingereicht: 13. Juni 2020

Angenommen: 17. Dezember 2020

Artikel online veröffentlicht:
25. Oktober 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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