The effect of single-dose, preoperative intravenous tranexamic acid on early postoperative pain scores after rotator cuff repair: a double-blind, randomized controlled trial
Tranexamic acid (TXA) is commonly used in upper and lower limb arthroplasty to limit blood loss and postoperative hematoma formation. The role of TXA in rotator cuff repair (RCR) surgery is less defined. This trial assessed the effect of preoperative TXA on early postoperative pain scores. A randomi...
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| Published in | Journal of shoulder and elbow surgery Vol. 31; no. 7; pp. 1399 - 1408 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Elsevier Inc
01.07.2022
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| Subjects | |
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| Abstract | Tranexamic acid (TXA) is commonly used in upper and lower limb arthroplasty to limit blood loss and postoperative hematoma formation. The role of TXA in rotator cuff repair (RCR) surgery is less defined. This trial assessed the effect of preoperative TXA on early postoperative pain scores.
A randomized double-blind trail was conducted in 89 patients undergoing RCR. Patients were randomized to either 2 g of intravenous TXA or placebo at induction. The primary outcome was visual analog scale (VAS)-pain score at day 3 postoperation, with secondary outcomes including VAS-pain, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), and Constant scores at 2, 8, 24, and 52 weeks.
There was no significant difference in VAS-pain scores between groups at day 3 postoperation. Pain scores were significantly better in the TXA group at 8 weeks. There was no difference between groups at any time point in the ASES or Constant score. The TXA group had improved motion at 6 months with a reduced rate of secondary adhesive capsulitis.
TXA did not improve postoperative pain scores after RCR, however, patients who received the intervention demonstrated greater range of motion at 6 months with lower rates of secondary adhesive capsulitis. |
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| AbstractList | BACKGROUNDTranexamic acid (TXA) is commonly used in upper and lower limb arthroplasty to limit blood loss and postoperative hematoma formation. The role of TXA in rotator cuff repair (RCR) surgery is less defined. This trial assessed the effect of preoperative TXA on early postoperative pain scores. METHODSA randomized double-blind trail was conducted in 89 patients undergoing RCR. Patients were randomized to either 2 g of intravenous TXA or placebo at induction. The primary outcome was visual analog scale (VAS)-pain score at day 3 postoperation, with secondary outcomes including VAS-pain, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), and Constant scores at 2, 8, 24, and 52 weeks. RESULTSThere was no significant difference in VAS-pain scores between groups at day 3 postoperation. Pain scores were significantly better in the TXA group at 8 weeks. There was no difference between groups at any time point in the ASES or Constant score. The TXA group had improved motion at 6 months with a reduced rate of secondary adhesive capsulitis. CONCLUSIONTXA did not improve postoperative pain scores after RCR, however, patients who received the intervention demonstrated greater range of motion at 6 months with lower rates of secondary adhesive capsulitis. Tranexamic acid (TXA) is commonly used in upper and lower limb arthroplasty to limit blood loss and postoperative hematoma formation. The role of TXA in rotator cuff repair (RCR) surgery is less defined. This trial assessed the effect of preoperative TXA on early postoperative pain scores. A randomized double-blind trail was conducted in 89 patients undergoing RCR. Patients were randomized to either 2 g of intravenous TXA or placebo at induction. The primary outcome was visual analog scale (VAS)-pain score at day 3 postoperation, with secondary outcomes including VAS-pain, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), and Constant scores at 2, 8, 24, and 52 weeks. There was no significant difference in VAS-pain scores between groups at day 3 postoperation. Pain scores were significantly better in the TXA group at 8 weeks. There was no difference between groups at any time point in the ASES or Constant score. The TXA group had improved motion at 6 months with a reduced rate of secondary adhesive capsulitis. TXA did not improve postoperative pain scores after RCR, however, patients who received the intervention demonstrated greater range of motion at 6 months with lower rates of secondary adhesive capsulitis. |
| Author | Patel, Shaan S. Cass, Benjamin Mackenzie, Samuel P. Bedaiwy, Najla Mattern, Owen Young, Allan Spasojevic, Miloš Piggott, Robert P. Smith, Margaret |
| Author_xml | – sequence: 1 givenname: Samuel P. orcidid: 0000-0001-6722-1340 surname: Mackenzie fullname: Mackenzie, Samuel P. organization: Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK – sequence: 2 givenname: Miloš orcidid: 0000-0003-1043-2192 surname: Spasojevic fullname: Spasojevic, Miloš email: milos.spasojevic.ortho@gmail.com organization: Sydney Shoulder Research Institute, St Leonards, NSW, Australia – sequence: 3 givenname: Margaret orcidid: 0000-0002-2020-0056 surname: Smith fullname: Smith, Margaret organization: Institute of Bone and Joint Research (University of Sydney) at Royal North Shore Hospital, St Leonards, NSW, Australia – sequence: 4 givenname: Owen surname: Mattern fullname: Mattern, Owen organization: Sydney Shoulder Research Institute, St Leonards, NSW, Australia – sequence: 5 givenname: Robert P. surname: Piggott fullname: Piggott, Robert P. organization: Sydney Shoulder Research Institute, St Leonards, NSW, Australia – sequence: 6 givenname: Shaan S. orcidid: 0000-0002-1111-683X surname: Patel fullname: Patel, Shaan S. organization: Sydney Shoulder Research Institute, St Leonards, NSW, Australia – sequence: 7 givenname: Najla orcidid: 0000-0002-8780-1868 surname: Bedaiwy fullname: Bedaiwy, Najla organization: Sydney Shoulder Research Institute, St Leonards, NSW, Australia – sequence: 8 givenname: Benjamin orcidid: 0000-0003-0120-4657 surname: Cass fullname: Cass, Benjamin organization: Sydney Shoulder Research Institute, St Leonards, NSW, Australia – sequence: 9 givenname: Allan orcidid: 0000-0002-0026-2161 surname: Young fullname: Young, Allan organization: Sydney Shoulder Research Institute, St Leonards, NSW, Australia |
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| Snippet | Tranexamic acid (TXA) is commonly used in upper and lower limb arthroplasty to limit blood loss and postoperative hematoma formation. The role of TXA in... BACKGROUNDTranexamic acid (TXA) is commonly used in upper and lower limb arthroplasty to limit blood loss and postoperative hematoma formation. The role of TXA... |
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| Title | The effect of single-dose, preoperative intravenous tranexamic acid on early postoperative pain scores after rotator cuff repair: a double-blind, randomized controlled trial |
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