Arslan Gülten, Mammadov Nihan Yaman, Önal Ceren, Mavi Fırat, Geyik Fatih Doğu, Eler Çevik Banu
Department of Anesthesiology and Reanimation, University of Health Sciences, Kartal Dr Lütfi Kırdar City Hospital, Istanbul, Turkey.
Ağrı Training and Research Hospital, Ağrı, Turkey.
World J Urol. 2025 May 13;43(1):300. doi: 10.1007/s00345-025-05581-w.
Tranexamic acid(TXA), an antifibrinolytic agent, is widely used to reduce bleeding, but its effect on pain is not clear.The purpose of this study was to evaluate the effectiveness of intravenous TXA on postoperative pain and bleeding in patients undergoing laparoscopic radical prostatectomy(LRP).
Our study was conducted as a prospective, observational study. Seventy patients aged 18-75years, ASA II-III, who would undergo LRP surgery under general anesthesia were included in the study.After anaesthesia induction, maintenance was provided with desflurane and 0.1-0.5mcg/kg/min remifentanil infusion with BIS monitoring.The control group(Group C) (n = 35) received 100 ml of saline and the study group(Group TXA) (n = 35) received TXA 15 mg/kg bolus 10 min before the incision and then 100 mg/hour infusion until skin closure. Demographic, hemodynamic data, ASA, education level, duration of operation and anesthesia, bleeding, administered fluid and remifentanil amounts, hemoglobin values(at the beginning of the operation, 2nd hours, end of the operation, postoperative 12th, 24th hours), Visual Analog Scale (VAS) (at 0th, 6th, 12th, 24th hours postoperatively), time to first rescue analgesia requirement, number of rescue analgesia used within 24h and side effects were recorded.
It was observed that VAS scores were statistically higher in TXA group at postoperative 0th and 6th hours, postoperative rescue analgesia requirement was higher and first rescue analgesia requirement time was shorter. No difference was determined between the groups in terms of other parameters.
In our study, we concluded that there was no significant difference in terms of bleeding in patients who were administered TXA, but this agent may cause hyperalgesia and a special approach to analgesia should be taken in cases where it is decided to be used.
GOV : (NCT06040853).
氨甲环酸（TXA）是一种抗纤溶药物，广泛用于减少出血，但其对疼痛的影响尚不清楚。本研究的目的是评估静脉注射TXA对接受腹腔镜前列腺癌根治术（LRP）患者术后疼痛和出血的有效性。
本研究为前瞻性观察性研究。纳入70例年龄在18 - 75岁、ASA II - III级、拟在全身麻醉下行LRP手术的患者。麻醉诱导后，采用地氟醚维持麻醉，并以0.1 - 0.5微克/千克/分钟的速率输注瑞芬太尼，同时进行脑电双频指数（BIS）监测。对照组（C组）（n = 35）输注100毫升生理盐水，研究组（TXA组）（n = 35）在切口前10分钟静脉推注TXA 15毫克/千克，然后以100毫克/小时的速率持续输注直至皮肤缝合。记录患者的人口统计学、血流动力学数据、ASA分级、教育水平、手术和麻醉持续时间、出血量、补液量和瑞芬太尼用量、血红蛋白值（手术开始时、第2小时、手术结束时、术后第12小时、第24小时）、视觉模拟评分法（VAS）（术后第0小时、第6小时、第12小时、第24小时）、首次需要补救镇痛的时间、24小时内使用的补救镇痛次数以及副作用。
观察发现，TXA组术后第0小时和第6小时的VAS评分在统计学上更高，术后补救镇痛的需求更高，首次需要补救镇痛的时间更短。两组在其他参数方面未发现差异。
在我们的研究中，我们得出结论，接受TXA治疗的患者在出血方面没有显著差异，但该药物可能会导致痛觉过敏，在决定使用时应采取特殊的镇痛方法。
GOV：（NCT06040853）
