Objective: To compare the efficacy of single-dose tranexamic acid versus placebo in reducing transfusion requirements and perioperative blood loss in females undergoing surgery for ovarian cancer. Methods: This randomized controlled trial was conducted in the Department of Obstetrics and Gynecology, Sheikh Zayed Hospital and Medical College, Rahim Yar Khan, over a 6-month period (December 2024 to May 2025). A total of 372 women aged 18–60 years with ovarian cancer of FIGO stage I–III and ASA class I–III were enrolled and randomized into two groups. Group A (n=186) received tranexamic acid 15 mg/kg intravenously before surgery, while Group B (n=186) received placebo. The primary outcome was efficacy, defined as no postoperative transfusion requirement. Results: All 372 patients completed the study. Baseline characteristics were comparable between groups (p >0.05). The requirement for transfusion was significantly lower in the tranexamic acid group (29.6%) compared to placebo (44.1%) (p=0.003). Efficacy was achieved in 70.4% of patients in the tranexamic acid group versus 55.9% in the placebo group (p=0.003). Mean perioperative blood loss was markedly reduced in the tranexamic acid group (548.3 ± 198.7 ml) compared to placebo (692.1 ± 242.6 ml) (p<0.001). Postoperative hemoglobin levels were significantly higher in the tranexamic acid group (10.2 ± 1.4 g/dl) compared to placebo (9.6 ± 1.6 g/dl) (p=0.001), with a smaller mean hemoglobin decline (1.6 ± 0.8 g/dl vs. 2.3 ± 1.2 g/dl, p<0.001). Conclusion: Single-dose tranexamic acid administered preoperatively significantly reduced transfusion requirements, perioperative blood loss, and hemoglobin decline in ovarian cancer surgery, supporting its use as an effective adjunct in perioperative management.
Naz et al. (Tue,) studied this question.