Background:

Tranexamic acid is a known antifibrinolytic the decreases blood loss. However, there is a debate about its ideal routine of administration in idiopathic scoliosis surgeries which involves significant soft tissue dissection and excessive bleeding. The aim of this study is to determine the effect of different loading doses of tranexamic acid with the same maintenance dose on the total blood loss in idiopathic scoliosis surgeries.

Methods:

A prospective cohort study performed at a single spine center. The first 79 patients who were indicated for AIS surgical correction who met our inclusion criteria were included in the study after obtaining informed consent. The patients were divided into 2 groups; group (A): 41 patients who received a loading dose of 10 mg/kg and group (B): 38 patients who received a loading dose of 50 mg/kg. Both had a maintenance dose of 1 mg/kg/h.

Results:

There were no statistically significant differences between the two studied groups in terms of total blood loss, blood loss per level, operative time, transfusion intraoperative, and transfusion post-operative.

Conclusion:

There was no significant difference in blood loss between using a loading dose of 10 mg/kg and 50 mg/ kg of TXA while using a maintenance dose of 1 mg/kg/h. This may reflect the importance of paying attention to the maintenance dose as well as the loading dose of TXA as the high-loading dose seems to lose its superiority over the low-loading dose if the maintenance dose is not proportionally high.