Category: Clinical Stones: PCNL

MP26-22 - Evaluation of the efficacy of tranexamic acid injection on surgical bleeding in percutaneous nephrolithotomy: A Randomized Clinical Trial

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective : The effect of Tranexamic Acid on the reduction of bleeding in various surgical procedures, especially in the field of urological surgeries has been proven. However, the effect of this drug on PCNL surgery is very limited. Given that, this surgery is highly susceptible to bleeding and it is difficult to control bleeding, the purpose of this study was to evaluate the effect of Tranexamic Acid injection on bleeding and PCNL surgery time.

Methods : In this prospective study, the patients were randomly divided into three groups. After the removal of patients who had the exclusion criteria, a control group (group 1) was considered, and in the case groups (group 2) 15 mg/kg Tranexamic Acid was Injected at the time of anesthesia induction and After 12 hours, three doses of 500 mg were injected every 8 hours. In the case group 3 , 10 mg/kg Tranexamic Acid Injected at the time of induction anesthesia and After 12 hours, three doses of 250 mg were injected every 8 hours. All information about the time of surgery, patient's demographic information and complications during surgery and blood transfusion and hemoglobin were checked 6 hours and 24 hours later and recorded in the questionnaire.

Results : A total of 272 patients were entered in this study, in which 87 patients were female and 185 were male. 96 patients were in group 1 with a mean age of 48.66 and 100 patients in group 2 with an average age of 44.21, 76 patients in the group 3 with an average age of 45.53. The mean size of the stones in the groups were 5.95,5.89 and 5.92 cm2 and this difference was not significant in the three groups (P:0.06). The mean reduction in hemoglobin in the first 6 hours was 1.62 gr/dl in group 1 and 1.61 gr/dl in group two and 1.59 gr/dl in group 3 which was not significant. (P:0.19) 9 patients in group one , 11 patients in group two and 6 patients received blood in group 3.

Conclusions : The use of Tranexamic Acid in PCNL surgery reduces the time of operation, but does not play a role in reducing bleeding during and after surgery.

Robab Maghsoudi

Associated professor
Urology Department,Iran University of Medical Science,Tehran,Iran.
Tehran, Tehran, Iran

Masoud Etemadian

Tehran, Tehran, Iran

Mojtaba Ameli

Tehran, Tehran, Iran

Iraj Meshki

Tehran, Tehran, Iran

Asaad Moradi