Perioperative Use Of Tranexamic Acid In Brain Tumor Resection: Effects On Intraoperative Blood Loss And Thrombosis Risk.

Abstract

Objective: To determine if there is a reduction in the amount of blood lost during surgery for patients with a brain tumor if tranexamic acid (TXA) is given before surgery.

Study Design: Prospective cohort study.

Setting and Duration: The Department of Neurosurgery, Mardan Medical Complex, Pakistan, from January 2020 to December 2024.

Methodology: 100 patients (n = 100) due to undergo a planned brain tumor resection volunteered. From the TXA group (n = 50), intravenous TXA 10 mg/kg was administered 30 minutes before induction; from the control group (n = 50), nothing was administered. The amount of blood loss during surgery, the number of transfusions required, the time taken to perform the surgery, and postoperative blood clotting events were noted. p=0.05 was used as the threshold for statistical significance.

Results: TXA reduced blood loss during surgery (480 +/- 130 vs 740 +/- 210; p < .001) and the need for blood transfusions (12% vs 28%) during these surgeries, confirming the first outcome. TXA and control group thromboembolism event rates of 4% and 6%, respectively; p = 0.64 (95% CI 0.23 – 2.15) indicates comparability in thromboembolic event rates and absence of new brain bleeding after surgery.

Conclusion: Preoperative TXA reduces blood loss and the need for blood transfusions, and does not increase the risk of thromboembolic complications after surgery. For selected patients undergoing neurosurgery, TXA can be deemed safe and effective.