40.Single Dose of IV Tranexamic Acid Preoperatively Reduces the Incidence of Post-Operative Scrotal Edema Following Lichtenstein Hernioplasty. A Randomized Prospective Cohort Analysis
Farhan Zaheer1, Qamaruddin Baloch1, Sidra Abbas2, Shafaq Naseer1, Osama Muhammad1 and Ayesha Anees1
Objective: to determine the single Dose of IV Tranexamic acid perioperatively reduces the incidence of post-operative scrotal oedema following Lichtenstein hernioplasty.
Study Design: A randomized prospective analysis
Place and Duration of Study: This study was conducted at the Civil Hospital Karachi, Pakistan from June, 2019 to December, 2020 for a period of six months.
Materials and Methods: All patients operated for inguinal hernia repair on elective basis at Surgical Unit of a tertiary care hospital was done after taking the approval from the hospital ethics committee. 40 patients in each group. All the patients aged between 18 and 65 years who underwent elective repair of inguinal hernia were a part of this study. Patients who were excluded from the study were the ones classified as ASA class III or IV by anaesthesiologist, patients with chronic end-organ diseases including CLD, CKD, CHF, history of intracranial haemorrhage, connective tissue disease or hypoalbuminemia, Patients with a history of convulsions, patients previously on anticoagulants and antiaggregant and patients having hypersensitivity to tranexamic acid.
Results: A total of 80 patients undergoing inguinal hernia repair were divided into 2 groups. The mean age for the control group was 39.33 ± 11.72, while for the intervention group was 41.53 ± 11.76 [p<0.05]. The most common complication apart from scrotal edema was urinary retention in both the groups. [27.5% in control vs 10% in TXA group], the rate of complications was more significant in control group [p=0.02]. The mean operating time for the intervention group was significantly reduced in the intervention group [68.25 ± 22.60 min vs 85.62 ± 31.78 min, p=0.006]. Edema resolved in 1.57 ± 1.44 days in intervention group while it took 4.85 ± 3.20 days for edema to resolve in the control group p<0.001. The patients who received TXA returned to work earlier than the ones without administration [p<0.001] along with a significantly reduced rate of complication [p<0.001].
Conclusion: A single dose of intravenous tranexamic acid 1gm can be safely administered to reduce scrotal edema following Lichtenstein hernioplasty with no demonstrable side effects.
Key Words: Lichtenstein hernioplasty; Tranexamic Acid; Scrotal edema; SERG score
Citation of article: Zaheer F, Baloch Q, Abbas S, Naseer S, Muhammad O, Anees A. Single Dose of IV Tranexamic Acid Preoperatively reduces the Incidence of Post-Operative Scrotal Edema Following Lichtenstein Hernioplasty. A Randomized Prospective Cohort Analysis. Med Forum 2021;32(10):180-184.