# Abstract

 

## Background: The radical surgical procedures are associated with perioperative blood loss. This study was aimed to evaluate the clinical efficacy and safety of tranexamic acid in reducing perioperative blood loss in patients undergoing radical surgery. 

## Materials and Methods: Sixty ASA class I and II adult consented female patients, scheduled for elective radical surgery and met the inclusion criterion, were blindly randomized into two groups to receive either intravenous 1 g tranexamic acid 20 min before skin incision or an equivalent volume of normal saline as placebo (P). All patient's total blood loss was measured and recorded perioperatively at the 12^th^h postoperatively. The preoperative and postoperative hemoglobin, hematocrit values, serum creatinine, activated thromboplastin time, prothombin time, thrombocyte count, fibrinogen, D-dimer, and symptoms of pulmonary embolism were comparatively evaluated. 

## Results: The tranexamic acid significantly reduced the quantity of total blood loss, 576 ± 53 mL in study group as compared to 823 ± 74 mL in the control group (*P*\<0.01). Postoperatively hematocrit values were higher in the tranexamic acid group. The coagulation profile did not differ between the groups, but D-dimer concentrations were increased in the control group. No complications or adverse effects were reported in the either group. 

## Conclusion: The prophylactic administration of tranexamic acid has effectively reduced theblood loss and transfusion needs during radical surgery without any adverse effects or complication of thrombosis. # RESULTS There was no significant difference in demographic data between groups. No significant difference was present between groups in mean hemoglobin, hematocrit, platelet count, fibrinogen values, and coagulation parameters. All radical surgeries were done under general anesthesia and standardized anesthetic technique was used for all patients of both groups \[[Table 1](#)\]. ::::table-wrap

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Demographic profile, preoperative hemoglobin and coagulation parameters
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![](<>):::: No significant difference was found between groups in mean hemoglobin, hematocrit, platelet count, fibrinogen values and coagulation parameters. The total measured blood loss (576 ± 53 mL) in tranexamic acid group was significantly less than control group (823 ± 74 mL) (*P*\<0.01). The need for blood transfusion was more in the control group. Only two patients in tranexamic acid group required allogeneic blood transfusion (Group TA 2 versus 15 of Group P) \[[Table 2](#)\]. Intraoperatively, the amount of crystalloid solution used for fluid replacement was comparable between the groups. ::::table-wrap
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Comparative values of measured blood loss, blood transfusions,
hemoglobin and coagulation profile
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![](<>):::: There were no clinically relevant differences in the vital signs in patients following tranexamic acid administration and no thromboembolic complications were detected in either group during hospitalization.


Extracted trial result:
Outcome: Total blood loss (continuous)
Intervention: Tranexamic acid
Comparator: Control
Intervention group size: 30
Intervention mean: 576
Intervention standard deviation: 53
Comparator group size: 30
Comparator mean: 823
Comparator standard deviation: 74
Notes: Had to infer that the group sizes were equal.