Role of tranexamic acid in reducing postoperative blood loss and transfusion requirement in patients undergoing hip and femoral surgeries

Pharmacological agents are used to reduce postoperative blood loss. To assess the effects of tranexamic acid on prevention of bleeding and requirement of blood transfusion after major hip and femoral surgeries. A prospective, randomized, double blinded study was conducted in the tertiary care teaching hospital. Ninety ASA grade I-II patients undergoing hip fracture surgery were included in this prospective study. Forty-five patients received tranexamic acid [TA] given in a bolus dose of 500 mg 15 min before surgical incision followed by continuous infusion. The remaining, 45 patients were allocated as a control group. Postoperative bleeding [volume of blood in the drain], percentage fall of hemoglobin, transfusions and complications were recorded. Mean volume of blood in the drain was 39.33 +/- 10.09 ml [mean +/- SD] as compared to 91.11 +/- 17.61 ml in placebo group showing a P<0.001. Mean percentage fall in Hb at day 0 was 2.99 +/- 3.45 in the study group as compared to 7.70 +/- 6.05 in the placebo group [P<0.001], and fall at day 2 in the study group was 0.35 +/- 0.74, compared to 2.72 +/- 2.70 in the placebo group [P<0.001]. The number of patients required blood transfusions were lower in the study group than in the placebo group [P=0.01]. We conclude that tranexamic acid significantly reduces postoperative blood loss and transfusion requirements during major hip and femoral surgeries

Comparison of three supraglottic devices in anesthetised paralyzed children undergoing elective surgery

The newest variation of the i-gel supraglottic airway is a pediatric version. This study was designed to investigate the usefulness of the size 2 i-gel compared with the Pro Seal laryngeal mask airway [PLMA] and classic laryngeal mask airway [CLMA] of the same size in anesthetized, paralyzed children. Settings and A prospective, randomized, single-blinded study was conducted in a tertiary care teaching hospital. Ninety ASA grade I-II patients undergoing lower abdominal, inguinal and orthopedic surgery were included in this prospective study. The patients were randomly assigned to the i-gel, PLMA and CLMA groups [30 patients in each group]. Size 2 supraglottic airway was inserted according to the assigned group. We assessed ease of insertion, hemodynamic data, oropharyngeal sealing pressure and postoperative complications. There were no differences in the demographic and hemodynamic data among the three groups. The airway leak pressure of the i-gel group [27.1 +/- 2.6 cm H[2]O] was significantly higher than that of the PLMA group [22.73 +/- 1.2 cmH2O] and the cLMA group [23.63 +/- 2.3 cm H[2]O]. The success rates for first attempt of insertion were similar among the three devices. There were no differences in the incidence of postoperative airway trauma, sore throat or hoarse cry in the three groups. Hemodynamic parameters, ease of insertion and postoperative complications were comparable among the i-gel, PLMA and cLMA groups, but airway sealing pressure was significantly higher in the i-gel group