Tranexamic acid for the Latarjet procedure: a randomized controlled trial
These authors assessed whether tranexamic acid (TXA) could reduce the incidence of postoperative swelling and hematoma formation and pain and opioid use in the early postoperative period. They conducted a randomized controlled trial in 100 patients undergoing open Latarjet surgery for anterior shoulder instability by an individual surgeon.
These authors assessed whether tranexamic acid (TXA) could reduce the incidence of postoperative swelling and hematoma formation and pain and opioid use in the early postoperative period. They conducted a randomized controlled trial in 100 patients undergoing open Latarjet surgery for anterior shoulder instability by an individual surgeon.
Patients were randomized to receive either 1 g TXA or a placebo intravenously preoperatively.
While there was no significant difference in intraoperative blood loss (60.9 vs. 68.9 mL), there was significantly lower postoperative blood loss (measured by drain output) with TXA (29.6 vs. 64.9 mL, P < .01).
There was a significantly lower rate of painful postoperative swelling (4% vs. 32%, P <.01) assessed by an examiner who was blinded to the treatment group of the patients.
Additionally, they found a significantly lower VAS score for pain (1.7 vs. 3.0, P <.01) and significantly less postoperative opioid use (9.4 vs. 22 mg, P < .01) in the TXA group.
Postoperative swelling was shown to correlate with increased pain and opioid use (P < .01).
Comment: In the Latarjet, as in many shoulder procedures, the amount of blood lost is not as much a concern as the swelling and pain that result from the accumulation of blood in the surgical field postoperatively. This randomized controlled trial nicely demonstrates the effectiveness of TXA in reducing hematoma formation and the discomfort related to it.
Comment: In the Latarjet, as in many shoulder procedures, the amount of blood lost is not as much a concern as the swelling and pain that result from the accumulation of blood in the surgical field postoperatively. This randomized controlled trial nicely demonstrates the effectiveness of TXA in reducing hematoma formation and the discomfort related to it.
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