Tranexamic acid (TXA) effectively reduces blood loss and transfusion risk during total joint arthroplasty. Additionally, intraoperative irrigation with various antiseptic solutions is often utilized for the management and prevention of surgical site infection. However, interactions between various antiseptic solutions and TXA have not been investigated. The purpose of this in vitro study is to evaluate the stability of TXA in the presence of common orthopedic antiseptic solutions. Five antiseptic solutions—0.1% chlorhexidine (CHX) gluconate, 10% povidone-iodine (BTD), 0.5% sodium hypochlorite (Dakin's), 3% hydrogen peroxide (H₂O₂), and 1.5% H₂O₂—and a 0.9% normal saline (NS) control were obtained. A stock 100 mg/ml TXA solution was diluted in each antiseptic solution to a concentration of 10.0 mg/ml to generate reference standard and stability samples. TXA stability in each solution was measured using high performance liquid chromatography at t = 0 and t = 120 min and reported as mean percent of theoretical concentration (MPT) with associated relative standard deviation (RSD). All experiments were performed in triplicate at room temperature. At t = 0 min, TXA remained stable when mixed with 0.9% NS, 0.1% CHX, 10% BTD, 3% H₂O₂, and 1.5% H₂O₂ (MPT range: 102.0%−105.0%, RSD range: 0.80%−2.92%). Only 0.5% Dakin's led to significant degradation of TXA at t = 0 min (MPT: 14.3%, RSD:1.28%). At t = 120 min, TXA stability persisted for all compounds except Dakin's 0.5% (MPT: 18.4%, RSD: 28.7%). TXA efficacy may be significantly diminished when 0.5% Dakin's is used as an intraoperative irrigation solution. CHX, BTD, and H₂O₂ do not degrade TXA.

中文翻译：

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氨甲环酸在多种消毒液存在下的稳定性分析

氨甲环酸 (TXA) 可有效降低全关节置换术中的失血和输血风险。此外，术中使用各种消毒液进行冲洗通常用于管理和预防手术部位感染。然而，尚未研究各种防腐溶液与 TXA 之间的相互作用。本体外研究的目的是评估 TXA 在常见骨科消毒液存在下的稳定性。五种消毒液——0.1% 氯己定 (CHX) 葡萄糖酸盐、10% 聚维酮碘 (BTD)、0.5% 次氯酸钠（Dakin's）、3% 过氧化氢 (H 2 O 2 )_和1.5 _% H ₂ O ₂- 并获得了 0.9% 的生理盐水 (NS) 对照。将 100 mg/ml TXA 储备液在每种消毒液中稀释至浓度为 10.0 mg/ml，以生成参考标准和稳定性样品。在t  = 0 和t  = 120 分钟时使用高效液相色谱测量每种溶液中的 TXA 稳定性，并报告为理论浓度 (MPT) 的平均百分比和相关的相对标准偏差 (RSD)。所有实验在室温下一式三份进行。在t = 0 分钟时，TXA 在与 0.9% NS、0.1% CHX、10% BTD、3% H ₂ O ₂和 1.5% H ₂ O ₂ 混合时保持稳定（MPT 范围：102.0%−105.0%，RSD 范围：0.80%−2.92%）。只有 0.5% Dakin's 在t = 0 分钟时导致 TXA 显着降解 （MPT：14.3%，RSD：1.28%）。在t  = 120 分钟时，除了 Dakin 的 0.5%（MPT：18.4%，RSD：28.7%）之外，所有化合物都保持 TXA 稳定性。当 0.5% Dakin's 用作术中冲洗液时，TXA 的疗效可能会显着降低。CHX、BTD 和 H ₂ O ₂不降解 TXA。