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Rezvani M, Tabesh H, Adimi M, Alavi M, Zareian A, Rahiminejad M et al . The Effect of Intravenous Tranexamic Acid Before and During Spinal Surgery in Bleeding Volume During and After Surgical Operation. Iran J Neurosurg 2019; 5 (2) :71-78
URL: http://irjns.org/article-1-121-en.html

Background and Aim: Bleeding during surgery is one of the most common surgical complications. In this study, we decided to determine the effect of Tranexamic Acid (TA) in reducing blood loss in patients undergoing spinal surgeries.
Methods and Materials/Patients: In this clinical trial, 100 patients undergoing spinal surgeries were randomly divided into two groups. One group received TA and the other was selected as the control group. Patients in the treatment group received 1 gram of intravenous TA and another 250 milligram intravenously, one hour after the beginning of the surgery. Bleeding during the surgery, in the first 24 hours and the first 48 hours were recorded separately. The need for transfusion and its volume, as well as the hospital stay length were compared in the two groups. 
Results: Bleeding during surgery in TA group was significantly lower than that in the control group (433 ml vs. 522 ml respectively, P=0.009). Also, during the first 24 hours after surgery, bleeding in
TA group was significantly less than that in the control group (P=0.011). During the second 24 hours after surgery, bleeding was similar between the two groups (P=0.112). The values of hemoglobin in both groups slowly decreased and the trend of decrease was not significantly different between them (P=0.154).
Conclusion: In spinal surgeries, TA administration in the beginning of the process reduces surgical bleeding during surgery and in the first 24 hours after surgery. Considering the possible complications, TA administration is suggested for patients with hemoglobin less than 12 g/dl. Future studies are needed to conclude the advantages and disadvantages of TA administration in spinal surgeries.