Tranexamic Acid in Pediatric Idiopathic Scoliosis Surgery
Efficacy and Safety of Two Intravenous Tranexamic Acid Regimens Versus Placebo in Pediatric Idiopathic Scoliosis Surgery: A Randomized Double-Blind Trial
Poznan University of Medical Sciences
90 participants
Jun 1, 2026
INTERVENTIONAL
Conditions
Summary
This study will evaluate whether tranexamic acid (TXA), a medication used to reduce bleeding, is effective and safe in children undergoing surgery for idiopathic scoliosis. Significant blood loss is common during this type of surgery and often requires blood transfusions. Participants will be randomly assigned to one of three groups: (1) TXA given as an intravenous bolus followed by continuous infusion, (2) TXA given as two intravenous bolus doses, or (3) placebo (saline). Neither the patients nor the medical team will know which treatment is given. The main goal is to compare how much blood is lost during and after surgery and whether TXA reduces the need for blood transfusions. The study will also assess safety, including the risk of side effects such as seizures or blood clots. Patients will be followed for up to 30 days after surgery.
Eligibility
Inclusion Criteria4
- Age 10 to 18 years
- Diagnosis of idiopathic scoliosis requiring surgical correction (posterior spinal fusion)
- American Society of Anesthesiologists (ASA) physical status I-II
- Written informed consent from parents or legal guardians and assent from the child
Exclusion Criteria6
- Congenital or acquired coagulopathy
- History of thromboembolic disease
- History of seizures or epilepsy
- Known hypersensitivity to tranexamic acid
- Renal insufficiency (estimated glomerular filtration rate < 60 mL/min/1.73 m²)
- Cardiac arrhythmias or cardiovascular disease requiring antiplatelet or anticoagulant therapy
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Interventions
Tranexamic acid administered intravenously as a 15 mg/kg bolus after induction of anesthesia, followed by continuous infusion at 1 mg/kg/h until the end of surgery.
Intravenous administration of 0.9% sodium chloride solution used as placebo, matched in volume and timing to the active comparator groups.
Tranexamic acid administered intravenously as two bolus doses: 10 mg/kg after induction of anesthesia and 10 mg/kg 120 minutes after surgical incision or at the beginning of rod placement, whichever occurs first.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07581457