Does Perioperative Use of Tranexamic Acid Prevent Bleeding?

Tranexamic acid (TXA) is an antifibrinolytic drug that promotes physiological hemostasis and is well established for preventing excess perioperative bleeding in cardiac and trauma surgery. A recent large trial (POISE-3) demonstrated that TXA also prevented bleeding in noncardiac surgery without causing excess cardiovascular or thrombotic events.

To further evaluate the efficacy and safety of TXA in general surgical procedures, investigators conducted a systematic review and meta-analysis of 26 randomized, placebo-controlled trials that involved 7000 patients, about half of whom received perioperative TXA. Sixteen trials involved abdominal surgeries, and 10 focused on head and neck procedures.