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

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.

Publication History

Received: 13 June 2020

Accepted: 17 December 2020

Article published online:
25 October 2021

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