Tranexamic Acid Reduce Blood Loss in Meningioma Resection

Effect of Tranexamic Acid Infusion to Reduce Intraoperative Blood Loss in Large Meningioma: A Prospective Randomized Double-blind Control Study

In neurosurgical setting, a large sample size trials of tranexamic acid (TXA) has been limited to TBI and SAH.

The evidence of TXA in brain tumor was scarce. A few case reports support the role of TXA in brain tumor patients with significant intraoperative bleeding and difficult achieving hemostasis. To prove the benefit of TXA for an attenuation of blood loss in brain tumor patients, research with a larger sample size is required. This prospective, randomized double-blind controlled study will be conducted to evaluate the effect of TXA in reducing blood loss and blood transfusion in patients with intracranial meningiomas, diameter > 5 cm in at least 2 dimensions from the latest radiographic findings.

Background and Literature review:

1. Meningioma
2. Coagulation in craniotomy to remove meningioma
3. Bleeding in craniotomy to remove meningioma
4. Tranexamic acid (TXA)
5. Knowledge gap The topics shown above has been reviewed to conduct a prospective randomized double-blind, placebo controlled study.

To prove the study hypothesis: Will intraoperative TXA administration in adult patients scheduled for craniotomy to remove large meningioma decrease blood loss?

Inclusion Criteria:

• The patients whose aged 18 to 60 years
• The patients who was diagnosed intracranial meningioma
• The radio-graphic finding of tumor diameter > 5 cm in at least 2 dimensions
• The patients have written informed consent
• The patients is scheduled for elective craniotomy to remove tumor

Exclusion Criteria:

• Patients who refuse to participate in this study
• Patients with recurrent tumor
• The patient is set operation for intracranial tissue biopsy
• The patients with history of TXA allergy
• The pregnant patients
• The patients with history of significant thromboembolic episode
• The patients with significant renal dysfunction (GFR ≤ 50 ml/min)