The effects of preoperative intravenous tranexamic acid on intraoperative blood loss in cancer surgeries at a tertiary care center in South India: A double-blind randomized controlled trial

Background: Tranexamic acid (TXA), initially used to treat heavy menstrual bleeding, has also been shown to significantly reduce perioperative blood loss in patients undergoing cytoreduction for advanced ovarian cancer. Objectives: The primary objective of this study was to assess the effects of preoperative intravenous TXA on blood loss during major oncological surgeries. The secondary objective was to evaluate the impact of TXA on blood transfusion rates. Materials and Methods: This prospective, double-blind, randomized control trial was conducted between January 2023 and February 2024 in the Department of Surgical Oncology at Tirunelveli Medical College Hospital, Tirunelveli, Tamil Nadu, India. Patients were randomly assigned to receive either TXA or a placebo. The primary end points were intraoperative blood loss and perioperative blood transfusion rates. Secondary end points included duration of hospital stay and the incidence of deep vein thrombosis (DVT) and pulmonary embolism. Results: Intraoperative blood loss averaged 241.7 ml in the control group and 194.6 ml in the TXA group ( P , 0.414). The control group had a mean hospital stay of 15.31 days, while the TXA group stayed for 17.29 days ( P , 0.215). Blood transfusions were required in 51.7% ( n = 31) of the control group and 33.3% ( n = 20) of the TXA group ( P , 0.155). Conclusion: This study concluded that TXA is a promising option for minimizing blood loss and the need for transfusions in major oncological surgeries, although statistical significance was not reached.