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Archives of Orthopaedic and Trauma Surgery

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01-01-2012 | Orthopaedic Surgery

Which is more effective in adolescent idiopathic scoliosis surgery: batroxobin, tranexamic acid or a combination?

Authors: Chengshi Xu, Anshi Wu, Yun Yue

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2012

Abstract

Background

Adolescent idiopathic scoliosis surgery is often associated with significant blood loss and blood transfusion. In this clinical trial, the authors investigated the efficacy of reducing blood loss and allogeneic blood transfusion by using batroxobin, tranexamic acid (TXA) and the combination of the two agents.

Methods

80 adolescent patients undergoing scheduled idiopathic scoliosis surgery were randomly divided into four groups to receive 0.9% saline (group A), batroxobin (group B), TXA (group C), and both two agents in the same manner (group D). The amounts of blood loss, transfusion requirements, frozen fresh plasma (FFP) and overall drainage were assessed. The hemoglobin concentration (Hb), hematocrit and platelet counts were recorded preoperative y, postoperatively and on the first operative day. The coagulation parameters were measured meanwhile. Deep vein thrombosis (DVT) was diagnosed by ultrasound.

Results

Blood loss of group B and group C decreased similarly by 35.3 and 42.8% (p = 0.212) compared with group A, while group D was reduced by 64.5, 45.1 and 37.8% compared to group A, B and C, respectively. The amount of allogeneic blood transfusion of group B and group C was comparably reduced by 57.6 and 72.4% compared to group A (p = 0.069), while group D decreased by 94.7, 87.5 and 80.9% compared to group A, B and C. Overall drainage of group B, C and D decreased by 23.0, 45.1 and 67.9% compared with group A, respectively, while group C was reduced by 28.7% compared with group B (p < 0.001). The FFP of group B, C and D was reduced by 63.4, 80.2 and 95.0% as compared with group A, while group C decreased by 45.9% as compared to group B (p = 0.025). There were no urgent coagulation disorders or DVT reported.

Conclusions

In our study, batroxobin and TXA can markedly reduce the blood loss and the transfusion requirements equivalently. However, TXA performs better in minimizing FFP and the overall drainage than batroxobin. The combination seems to achieve best results and was more effective than either of the two drugs alone. No apparent adverse events were detected in these groups.

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Title: Which is more effective in adolescent idiopathic scoliosis surgery: batroxobin, tranexamic acid or a combination?
Authors: Chengshi Xu
Anshi Wu
Yun Yue
Publication date: 01-01-2012
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2012
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-011-1390-6

At a glance: The STEP trials

Springer Medicine

Which is more effective in adolescent idiopathic scoliosis surgery: batroxobin, tranexamic acid or a combination?

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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