Single intravenous bolus vs. continuous infusion of tranexamic acid to reduce blood loss in transurethral resection of prostate: a prospective randomized double-blind study

Background and objective: Intraoperative a single bolus of tranexamic acid may be inadequate to prevent bleeding in the early postoperative period. We compared the effect of two dose regimens of tranexamic acid in reducing perioperative blood loss and the amount of allogeneic blood transfusion in transurethral resection of prostate (TURP). Methods: A total of 50 patients electively posted for TURP, were randomly assigned to receive either a single bolus dose of tranexamic acid 10 mg/kg (Group A), or a bolus of tranexamic acid 10 mg/kg followed by an infusion of tranexamic acid @1 mg/kg/h till 4 h postoperatively (Group B). Perioperative blood loss and the amount of blood transfused were the primary outcome. Postoperative hemoglobin and hematocrit levels, incidence of deep vein thrombosis and any convulsions were the secondary outcomes. Results: There was no significant difference among patients in both groups regarding intraoperative and postoperative blood loss at 6 h and 48 h postoperatively. However, the postoperative blood loss at 24 h was significantly higher among patients in Group A (P = 0.014). Conclusion: Tranexamic acid used as intravenous bolus followed by infusion continued in the postoperative period is more effective in reduction of perioperative blood loss in comparison to single bolus in transurethral resection of prostate. Abbreviations: TURP: transurethral resection of prostate, TXA: tranexamic acid, Hct: hematocrit, DVT Key words: Antifibrinolytics, blood loss, transurethral resection of prostate, tranexamic acid. Citation: Ghaly Tawadros SI, Kamal MM, Mohammed EA, Khairy MA. Single intravenous bolus vs. continuous infusion of tranexamic acid to reduce blood loss in transurethral resection of prostate: a prospective randomized double-blind study. Anaesth. pain intensive care 2025;29(2):210-216. DOI: 0.35975/apic.v29i2.2705 Received: November 10, 2024; Reviewed: February 03, 2025; Accepted: February 05, 2025