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- Klinische proef NCT01136590
Multicenter, Randomized Placebo-controlled Clinical Trial to Evaluate the Effect of Perioperative Use of Tranexamic Acid on Transfusion Requirements and Surgical Bleeding in Major Spine Surgery
Current evidence regarding the efficacy and safety of perioperative administration of tranexamic acid for antifibrinolysis does not suffice to support its use in major spinal surgery.
OBJECTIVES: To evaluate the effectiveness of tranexamic acid for decreasing transfusion requirements and bleeding in this patient population. To evaluate the safety of this antifibrinolytic agent in the intraoperative and mid-term postoperative period.
METHODS: Multicenter, randomized, double-blind, placebo-controlled clinical trial with parallel groups. The main outcome measure is intraoperative and postoperative transfusion requirements; blood loss and safety will also be evaluated. Previous results in other types of surgery suggest that tranexamic acid reduces transfusion requirements and blood loss. Hence, the hypothesis of this study is that tranexamic acid will significantly reduce blood loss in comparison to a placebo in major spine surgery.
Studie Overzicht
Toestand
Interventie / Behandeling
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 4
Contacten en locaties
Studie Locaties
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Barcelona, Spanje, 08035
- Hospital Vall d'Hebron de Barcelona
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Barcelona, Spanje, 08029
- Hospital Clinic de Barcelona
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Barcelona
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Hospitalet de Llobregat, Barcelona, Spanje
- Hospital de Bellvitge
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Madrid
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Getafe, Madrid, Spanje
- Hospital de Getafe
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Patients ≥18 years old of both sexes
- scheduled for complex spine surgery
- ASA I-III
- weighing more than 30 kg
- body mass index <30 kg/m2
- operated on in the participating hospitals
- major spinal surgery
- signed an informed consent form to be included in the study
Exclusion Criteria:
- a history of allergy or hypersensitivity to the agent used
- receiving medication that can interfere with coagulation (acetylsalicylic acid, oral anticoagulants, or antiplatelet agents)
- a history of frequent bleeding
- plasma creatinine values >1.5 mg/dL in the baseline analysis
- platelet count less than 150,000/mm3 in the follow-up analysis
- abnormal prothrombin time (INR >1.5) or partial thromboplastin time (INR >1.5)
- a history of a thromboembolic episode before surgery
- family history of thromboembolism
- lack of consent to participate in the study
- infectious disease, tumor or trauma of the spine as the reason for surgery
- scheduled for surgery with an anterior and posterior surgical approach, whether sequential or on the same day
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verviervoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: tranexamic acid
tranexamic acid will be administered as a bolus (10-mg/kg dose ) or as a fast, 20-minute intravenous infusion before performing the incision at the start of surgery, followed by perfusion of 2 mg/kg/hour up to the time the surgical wound is closed at completion of surgery
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A 10-mg/kg dose of tranexamic acid will be administered as a bolus or as a fast, 20-minute intravenous infusion before performing the incision at the start of surgery, followed by perfusion of 2 mg/kg/hour up to the time the surgical wound is closed at completion of surgery.
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Placebo-vergelijker: placebo
The placebo will be administered according to the same regimen and infusion time as the medication in the study arm (bolus or 20-minute fast infusion before the incision at the beginning of surgery followed by perfusion of 2 mg/kg/hour until closure of the surgical wound at completion of surgery)
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The placebo will be administered according to the same regimen and infusion time as the medication in the study arm (bolus or 20-minute fast infusion before the incision at the beginning of surgery followed by perfusion of 2 mg/kg/hour until closure of the surgical wound at completion of surgery)
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
|---|---|
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The primary outcome measure is the number of transfused units required during the intraoperative and postoperative period
Tijdsspanne: 7 days postoperative period
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7 days postoperative period
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Total blood loss: intraoperative and postoperative values
Tijdsspanne: 48 hours postoperative
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Intraoperative blood loss is evaluated by measuring the volume of suction aspirate and weighing the swabs with a precision digital scale.
Postoperative blood loss is determined by recording the volume of blood collected through the suction drains at 24 and 48 hours.
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48 hours postoperative
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Adverse events in the perioperative period, immediate postoperative period, and at mid-term
Tijdsspanne: up to 6 weeks after the procedure
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Adverse events in the perioperative period, immediate postoperative period, and at mid-term (up to 6 weeks after the procedure) will be recorded, with special emphasis on follow-up of thrombotic events and clinically suspected deep venous thrombosis, renal function, and visual abnormalities reported by the patient
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up to 6 weeks after the procedure
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Medewerkers en onderzoekers
Medewerkers
Onderzoekers
- Studie stoel: Maria J Colomina, MD Ph, Hospital Vall d'hebrón
- Hoofdonderzoeker: Misericordia Basora, MD Ph, Hospital Clinic of Barcelona
- Hoofdonderzoeker: Maylin Koo, MD Ph, Hospital Universitari de Bellvitge
- Hoofdonderzoeker: Javier Pizones, MD, Hospital de Getafe.
Publicaties en nuttige links
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- TRANEX2009
- 2008-006938-94 (EudraCT-nummer)
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