RESULTS
A total of 150 patients planned for hysterectomy for benign conditions
were made a part of this prospective case-control study. Both the groups
were matching with regard to demographic data (table 1) like blood
pressure, pulse rate, and BMI. Heavy menstrual bleeding was seen as the
most common complaint amongst the subjects undergoing hysterectomy,
followed by the feeling of something coming out per vaginum while AUB-L
was seen as the most common indication of hysterectomy followed by 3°
cervical descent with rectocele and enterocele. Preoperative hemoglobin
levels were shown to be higher in the control group, but an inverse
correlation was found to be statistically significant
(p<0.019). Similarly, postoperative hemoglobin values were
found to be higher in the case group, which was statistically
significant (p<0.031). There were a variety of routes followed
for hysterectomy, out of which TAH with salpingectomy was the most
common, followed by VH with anterior colporrhaphy and posterior
colpoperineorrhaphy.As shown in table table 2, the mean intraoperative
blood loss in the case group was seen to be 489 ml, while in the control
group, it was 540ml, which was seen to be statistically significant. The
intraoperative blood loss was overall decreased in the case group
irrespective of the route of hysterectomy (table 3). This was found to
be statistically significant only for vaginal hysterectomy with anterior
colporrhaphy and posterior colpoperineorrhaphy. The difference in
intraoperative blood loss between the case and the control groups was
also found to be statistically significant (p<0.02). The
weight of the hysterectomy sample obtained postoperatively was also
found to be higher in the group, which received tranexamic acid, and
this difference was found to be statistically significant as well
(p<0.05). On the contrary, the requirement for blood or blood
product transfusions (intraoperative to postoperative day 7) was seen to
be higher in the case group, which was also statistically significant
(p<0.02). Also, the mean duration of hospital stay
post-hysterectomy was shown to be higher in the case group, but the
difference was not found to be statistically significant
(p<0.09).
Intraoperative blood loss was directly proportional and significant for
the weight of the hysterectomy sample obtained and was independent of
the use of tranexamic acid, p<0.01. Also, the intraoperative
blood loss was seen to be more in the cases operated in general
anesthesia than spinal anesthesia. These values were also found to be
statistically significant, p<0.04. A correlation was also
found between the intraoperative blood loss and the size of the uterus,
p<0.01. It was seen that as the size increased, the blood loss
increased proportionally, irrespective of the use of TXA.
With respect to the side effects of tranexamic acid, it was shown that
the incidence of nausea and vomiting in the case and the control group
(7 v/s 0 respectively) and diarrhea (2 and 1 respectively). There was no
evidence found of serious adverse effects of tranexamic acid-like visual
disturbances, hypotension, or venous thromboembolism.