ArticleCureus2024
Right Drug in the Wrong Place: The Effects of Inadvertent Intrathecal Tranexamic Acid.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Refractory Status Epilepticus Following Erroneous Intrathecal Injection of Tranexamic Acid: A Case Report and Long-Term Follow-Up and Narrative Review.Case reports in anesthesiology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Tranexamic acid (TXA) is an antifibrinolytic drug widely used to reduce blood loss in major surgeries and trauma patients, thus reducing morbimortality. In recent years, clinical indications for TXA have expanded, including many off-label uses. This broad use has led to an increased incidence of reported side effects and administration errors with serious neurological and cardiovascular outcomes, such as seizures, myoclonus, and arrhythmias. This case report describes a 75-year-old female, American Society of Anesthesiologists (ASA) physical status III, who underwent lumbar spine surgery and received topical TXA for hemostatic control despite intraoperative incidental dural tears. Postoperatively, the patient experienced severe back pain, perianal burning, and painful lower limb myoclonus, prompting emergency surgery to rule out surgical complications. Despite no structural issues being identified, her symptoms persisted, requiring reintubation, sedation, and ICU admission. On the first postoperative day, no further pain or myoclonus was present with analgosedation and mechanical ventilation weaning. The patient's clinical condition improved gradually, being discharged one week later with no further complaints or neurological sequelae. TXA reduces inhibitory neurotransmission of γ-Aminobutyric acid type A (GABA-A) and glycine receptors with increased neuronal excitability and potential proconvulsant properties. This mechanism of action is responsible for the clinical features of acute neurotoxicity with imbalanced inhibitory-excitatory motor, sensory, and autonomic neurotransmission following intrathecal TXA. This case report intends to increase awareness for early recognition of the neurotoxic effects following inadvertent intrathecal TXA. The authors are unaware of other reports regarding this clinical feature as a complication from spinal topical use, enhancing the importance of dural integrity before considering topical TXA administration. Any dural tear could allow TXA to enter the intrathecal space, potentially leading to severe neurotoxic effects. In conclusion, further studies are required to evaluate the safety, efficacy, and clinical indications for topical TXA, particularly in spine surgery, to provide a safer use of this promising drug.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.