Effect of tranexamic acid solution in warm, cold, and room temperature irrigation fluid on complications during and after TURP surgery: a double-blind, randomized clinical trial

Abstract Background and purpose: Transurethral resection of the prostate (TURP) is a surgical technique commonly used for benign prostatic hyperplasia. The most significant complications of this surgery are bleeding intraoperatively and shivering postoperatively. In this study, we aimed to investigate the effect of tranexamic acid (TXA) solution in warm, cold, and room-temperature irrigation fluid on these complications during and after TURP surgery. Materials and Methods: This study was a double-blind clinical trial conducted in Iran; 100 candidates for TURP surgery were selected using the Convenience sampling method and based on the intraoperative irrigation method: intervention group A (TXA compound solution in cold irrigation fluid), intervention group B (composition of TXA dissolved in room temperature irrigation fluid), intervention group C (TXA compound solution in cold irrigation fluid) and group control (routine irrigation). Intraoperative bleeding was measured with a photometer, hemoglobin was measured with a blood cell counter (Cell-Dyn3200), and post-operative shivering was measured using the Crossley and Mahajan scale. Findings: The amount of postoperative bleeding in the TXA solution in the cold irrigation fluid group was significantly lower than in the other groups. Post-operative shivering was significantly lower in the TXA solution group in warm irrigation fluid and the highest in the cold group. The data was analyzed using SPSS version 16. Conclusion: The results of this study showed that the composition of TXA in the cold irrigation solution potentially reduces intraoperative bleeding, but the amount of shivering postoperatively is more significant than in the warm solution and at room temperature.