Efficacy and safety of epsilon-aminohexanoic acid and tranexamic acid 1 in posterior interbody fusion surgery

Dilixiati Ainiwaer^1*Ayinuer Tuersun²Jiang Li^1*Xiaomei Li²

• ¹Sixth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
• ²The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, China

Methods Retrospective analysis of 180 patients with lumbar disc herniation, lumbar spinal stenosis, and lumbar spondylolisthesis admitted to the Spinal Surgery Department of the Sixth People's Hospital of Xinjiang Uygur Autonomous Region from September 2021 to May 2023, who underwent PLIF.According to the types of hemostatic drugs used during the perioperative period,they were divided into two groups,namely EACA group (n=86) and TXA group (n=94).The main outcome measures are total blood loss,total red blood cell loss,and transfusion volume/rate;Other outcome measures:length of hospital stay,hospitalization costs, deep vein thrombosis rate, and biochemical hematological indicators,including anemia,nutrition, and coagulation related indicators.Results ①The red blood cell width of the EACA group was (43.94±10.56), while that of the TXA group was (40.45 ± 12.54). The red blood cell width of the EACA group was significantly higher than that of the TXA group, and the difference between the two groups was statistically significant (p<0.05).② The postoperative total protein of the EACA group was (56.17±7.83), while that of the TXA group was (59.3628±6.73).The postoperative total protein of the TXA group was significantly higher than that of the EACA group, and the difference between the two groups was statistically significant (p<0.05).③The postoperative INR of the EACA group was (1.06±0.14), while the postoperative total protein of the TXA group was (1.14±0.13). The postoperative INR of the TXA group was significantly higher than that of the EACA group, and the difference between the two groups was statistically significant (p<0.05).There was no statistically significant difference between the two groups in other indicators.Conclusion There is no significant difference in total blood loss,total red blood cell loss,transfusion volume/rate,postoperative hospitalization time,hospitalization costs,and surgical complications between intravenous EACA and TXA in PLIF.The two have similar hemostatic effects and safety.Therefore,when selecting anti fibrinolytic drugs during PLIF surgery,EACA canbe considered as a substitute drug for TXA.However,large-scale,multicenter randomized controlled studies are still needed in the later stage.