Use of tranexamic acid in scoliosis surgery

Objective. To assess the effectiveness of tranexamic acid in the surgical correction of idiopathic scoliosis. Material and Methods. The study included a retrospective analysis of intraoperative and postoperative blood loss during surgical correction of idiopathic scoliosis in 198 patients. In 70 patients, the operation was performed without administra- tion of tranexamic acid. In 58 patients, tranexamic acid was administered 15 minutes before the skin incision at a dose of 10 mg/kg, and continued uninterruptedly at a dose of 1 mg/kg/h. In 70 patients, tranexamic acid was administered con- tinuously during the operation at a dose of 10 mg/kg. Patients underwent surgery in a prone position with full decompres- sion of the anterior abdominal wall. Results. The registered intraoperative blood loss in most cases corresponded to Class I (no more than 750 ml or 15 % of blood volume) and Class II (no more than 750–1500 ml or 15–30 % of blood volume) according to the WHO classifica- tion of severity. The volume of intraoperative blood loss was not statistically different between groups. Significant differ- ences were detected only in assessing parameters of postoperative blood loss. Conclusion. The use of tranexamic acid in surgical correction of scoliosis does not affect the bleeding index of tissues at the surgical site and the total intraoperative blood loss. Using tranexamic acid in spine surgery is a technological procedure al- lowing for significant reduction in postoperative blood loss