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NCT Number: NCT01136590

Multicenter, Randomized Placebo-controlled Clinical Trial to Evaluate the Effect of Perioperative Use of Tranexamic Acid on Transfusion Requirements and Surgical Bleeding in Major Spine Surgery

Current evidence regarding the efficacy and safety of perioperative administration of tranexamic acid for antifibrinolysis does not suffice to support its use in major spinal surgery.

OBJECTIVES: To evaluate the effectiveness of tranexamic acid for decreasing transfusion requirements and bleeding in this patient population. To evaluate the safety of this antifibrinolytic agent in the intraoperative and mid-term postoperative period.

METHODS: Multicenter, randomized, double-blind, placebo-controlled clinical trial with parallel groups. The main outcome measure is intraoperative and postoperative transfusion requirements; blood loss and safety will also be evaluated. Previous results in other types of surgery suggest that tranexamic acid reduces transfusion requirements and blood loss. Hence, the hypothesis of this study is that tranexamic acid will significantly reduce blood loss in comparison to a placebo in major spine surgery.

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Key information

Conditions

Spinal Fusion Antifibrinolytic Agents Blood Transfusion Hemorrhage Pathologic Processes Pathological Conditions, Signs and Symptoms

Age range

18 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

Hospital Clinic de Barcelona, Barcelona, Spain

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients ≥18 years old of both sexes
  • scheduled for complex spine surgery
  • ASA I-III
  • weighing more than 30 kg
  • body mass index <30 kg/m2
  • operated on in the participating hospitals
  • major spinal surgery
  • signed an informed consent form to be included in the study

Exclusion criteria

  • a history of allergy or hypersensitivity to the agent used
  • receiving medication that can interfere with coagulation (acetylsalicylic acid, oral anticoagulants, or antiplatelet agents)
  • a history of frequent bleeding
  • plasma creatinine values >1.5 mg/dL in the baseline analysis
  • platelet count less than 150,000/mm3 in the follow-up analysis
  • abnormal prothrombin time (INR >1.5) or partial thromboplastin time (INR >1.5)
  • a history of a thromboembolic episode before surgery
  • family history of thromboembolism
  • lack of consent to participate in the study
  • infectious disease, tumor or trauma of the spine as the reason for surgery
  • scheduled for surgery with an anterior and posterior surgical approach, whether sequential or on the same day

Treatment and study plan

Tranexamic Acid

Drug

A 10-mg/kg dose of tranexamic acid will be administered as a bolus or as a fast, 20-minute intravenous infusion before performing the incision at the start of surgery, followed by perfusion of 2 mg/kg/hour up to the time the surgical wound is closed at completion of surgery.

fisiologic serum

Drug

The placebo will be administered according to the same regimen and infusion time as the medication in the study arm (bolus or 20-minute fast infusion before the incision at the beginning of surgery followed by perfusion of 2 mg/kg/hour until closure of the surgical wound at completion of surgery)

Primary outcomes

  1. The primary outcome measure is the number of transfused units required during the intraoperative and postoperative period

    Time frame: 7 days postoperative period

Secondary outcomes

  1. Total blood loss: intraoperative and postoperative values

    Time frame: 48 hours postoperative

    Intraoperative blood loss is evaluated by measuring the volume of suction aspirate and weighing the swabs with a precision digital scale. Postoperative blood loss is determined by recording the volume of blood collected through the suction drains at 24 and 48 hours.

  2. Adverse events in the perioperative period, immediate postoperative period, and at mid-term

    Time frame: up to 6 weeks after the procedure

    Adverse events in the perioperative period, immediate postoperative period, and at mid-term (up to 6 weeks after the procedure) will be recorded, with special emphasis on follow-up of thrombotic events and clinically suspected deep venous thrombosis, renal function, and visual abnormalities reported by the patient

Sponsors and collaborators

Lead sponsor

Hospital Universitari Vall d'Hebron Research Institute

Other

Collaborators

  • Hospital Clinic of Barcelona
  • Hospital Universitari de Bellvitge
  • Hospital Universitario Getafe
  • Hospital Vall d'Hebron

Registry information

Important dates

Study start
2010
Primary completion
2014
Study completion
2014
First posted
Jun 3, 2010
Registry last updated
Feb 24, 2015

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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