Effect of time of discontinuing clopidogrel administration before operation on blood-saving effect of tranexamic acid / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the effect of time of discontinuing clopidogrel administration be-fore operation on blood-saving effect of tranexamic acid. Methods One hundred and eighty patients of both sexes, aged 18-70 yr, weighing 45-85 kg, scheduled for elective first coronary artery bypass grafting under cardiopulmonary bypass, were divided into A, B and C groups(n=60 each)according to clopi-dogrel use before operation. In group A, clopidogrel 75 mg∕d was taken orally, and time of stopping clopi-dogrel administration before operation <7 days. In group B, clopidogrel 75 mg∕d was taken orally, and time of stopping use of clopidogrel before operation≥7 days. Patients received no clopidogrel before opera-tion in group C. After induction of anesthesia, tranexamic acid was infused at a loading dose of 10 mg∕kg o-ver 20 min, followed by an infusion of 10 mg·kg-1·h-1until the end of operation. Blood loss and re-quirement for allogeneic erythrocytes,plasma and platelet were recorded before removal of drainage tubes af-ter operation. The dose of heparin and protamine was recorded. The development of perioperative adverse reactions was also recorded. Results There was no significant change in the amount of heparin and prota-mine, ratio of protamine to heparin for heparin neutralization or incidence of perioperative adverse reactions between the three groups(P>0.05). Compared with group C, the incidence of major bleeding, transfusion of and requirement for allogeneic erythrocytes, plasma and platelets were significantly increased in group A (P<0.05), and no significant change was found in the parameters mentioned above in group B(P>0.05). There was no significant difference in postoperative blood loss or transfusion of allogeneic erythrocytes, plas-ma and platelets between group B and group A(P>0.05). Conclusion The time of discontinuing clopi-dogrel administration before operation exerts no effect on blood-saving effect of tranexamic acid.