Genel Anestezi ve Spinal Anestezi Altında Gerçekleştirilen Sezaryen Operasyonlarında Farklı Dozlarda Kullanılan Traneksamik Asit Dozunun Karşılaştırılması

Objective: Every two minutes, a pregnancy-related death occurs worldwide, with one-third of these deaths being associated with bleeding.Tranexamic acid (TA) is an antifibrinolytic agent used to limit bleeding.We aimed to evaluate the efficacy of TA on bleeding by retrospectively reviewing the records of patients who underwent cesarean section (C/S) under general or spinal anesthesia; comparing groups administered different doses of TA within the same anesthetic method, as well as cases managed with different anesthetic techniques despite receiving identical TA doses.Method: The study included 300 patients in total by retrospectively analyzing C/S procedures carried out under spinal and general anesthesia.Each anesthesia method was analyzed separately to assess the effects different doses of TA on bleeding, bleeding parameters, transfusion requirements, and intraoperative fluid administration.Additionally, groups administered the same dose of TA but different anesthetic methods were compared among themselves.Results: In our study, the preoperative and postoperative hemoglobin (Hb) and hematocrit (Hct) values and the amount of bleeding in patients who received 1000 mg of TA in the general anesthesia group were statistically significantly lower than in patients in the other groups.In the spinal anesthesia group that received 1000 mg of TA, no significant difference was observed in Hb and Hct levels, but the amount of bleeding was found to be lower.Transfusion requirements did not differ significantly between the various TA dose groups across both anesthesia techniques.Conclusion: Our study demonstrated that TA significantly reduces bleeding, with the most effective reduction observed at a 1000 mg dose.When comparing both anesthesia methods, we found that TA was more effective in reducing bleeding in patients who underwent general anesthesia.Based on these results, we conclude that TA has a particularly positive impact on the clinical outcomes of pregnant women receiving general anesthesia for C/S procedures.