Ranawat Süspansiyonunun Traneksamik Asit ile Kombine Periartiküler Enjeksiyonu Total Diz Artroplastisinde Kanama ve Ameliyat Sonrası Ağrıyı Azaltabilir

Year 2022, , 120 - 125, 15.10.2022

Ülker Moralar , Çağdaş Pamuk

https://doi.org/10.53446/actamednicomedia.1146576

Abstract

Amaç: Lokal anestezik ajanların veya traneksamik asidin periartiküler enjeksiyonlarının faydaları daha önce bir çok ortopedik çalışmada postoperatif ağrı üzerindeki etkileri açısından değerlendirilmiştir. Ancak bu amaçla kullanılabilecek lokal anestezik ve traneksamik asit kombine kullanımının etkinliğine ilişkin veriler henüz ortaya koyulmamıştır. Bu çalışmada total diz artroplastisi uygulanan hastalarda hem traneksamik asit hem de Ranawat süspansiyonunun periartiküler enjeksiyonunun postoperatif ağrı ve kanama üzerine etkilerini araştırmayı amaçladık.
Yöntem: Bu çalışmaya total diz artroplastisi uygulanan toplam 124 hasta dahil edildi. Hastalar iki gruba ayrıldı: Ranawat süspansiyonu ve Traneksamik asit kombinasyonunu içeren bir kokteylin periartiküler enjeksiyonunu alanlar ve enjeksiyon yapılmayanlar. Gruplar arasında ameliyat sonrası ağrı, ameliyat sonrası tramadol ihtiyacı ve kan kaybı karşılaştırıldı.
Bulgular: Periartiküler Ranawat süspansiyonu ve traneksamik asit kombinasyonu uygulanlarda postoperatif üçüncü günde hemoglobin ve hematokrit seviyeleri anlamlı olarak yüksekti (sırasıyla p=0,044 ve p=0,047). Ayrıca periartiküler enjeksiyon yapılmayan hastalarda drenaj kan kaybı miktarı (p<0,001) ve kan transfüzyonu ihtiyacı (p=0,009) anlamlı olarak daha yüksekti. Ayrıca, periartiküler enjeksiyon alan hastalarda, enjeksiyon yapılmayanlara kıyasla ilk 72 saat içinde analjezik gereksinimleri de önemli ölçüde daha düşüktü.
Sonuç: Total diz artroplastisi uygulanan hastalarda Ranawat süspansiyonu ve traneksamik asit kombinasyonunu içeren bir kokteylin periartiküler enjeksiyonu majör komplikasyonlarda artışa neden olmadan kan kaybı, ağrı ve ek analjezik gereksinimini azaltmada etkilidir.

Keywords

Ranawat süspansiyonu, traneksamik asit, postoperatif ağrı, kan transfüzyonu, postoperatif analjezi

Periarticular Injection of Ranawat Suspension in Combination with Tranexamic Acid Reduces Bleeding and Postoperative Pain in Total Knee Arthroplasty

Abstract

Objective: The benefits of periarticular injections of local anesthetic agents or tranexamic acid have been previously evaluated in terms of their effects on postoperative pain in a number of orthopedic studies. However, data is lacking on the efficacy of local anesthetic and tranexamic acid combinations that may be used for this purpose. We aimed to investigate the effects of periarticular injection of both tranexamic acid and Ranawat suspension on postoperative pain and bleeding in patients undergoing total knee arthroplasty.
Methods: A total of 124 patients who underwent total knee arthroplasty were consecutively enrolled in this study. Patients were divided into two groups: those receiving the periarticular injection of a cocktail containing the combination of Ranawat suspension and Tranexamic acid and those receiving no injections. Postoperative pain, postoperative tramadol requirement and blood loss were compared between groups.
Results: Hemoglobin and hematocrit levels were significantly higher at third day postoperatively in recipients of periarticular Ranawat suspension and tranexamic acid combination (p=0.044 and p=0.047, respectively). In addition, the amount of drainage blood loss (p<0.001) and need for blood transfusions (p=0.009) were significantly higher in patients receiving no periarticular injections. Moreover, analgesic requirements were also significantly lower during the first 72 hours in recipients of periarticular injections compared to those receiving no injections.
Conclusion: Periarticular injection of a cocktail containing the combination of Ranawat suspension and tranexamic acid in patients undergoing total knee arthroplasty is effective in reducing blood loss, pain and additional analgesic requirement, without causing an increase in major complications.

Keywords

Ranawat suspension, tranexamic acid, postoperative pain, blood transfusion, postoperative analgesia

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