Gastric POCUS, 3-Part Episode

Antifibrinolytic medications may be given to patients undergoing major scoliosis repair in order to decrease bleeding and risk of a blood transfusion. Tranexamic acid is a lysine analog that prevents fibrinolysis by binding to the lysine binding site on plasminogen and competitively inhibiting the conversion of plasminogen to plasmin. Thus, there is less plasmin for the degradation of fibrin. Administration of tranexamic acid in total doses greater than 80-100 mg/kg may be associated with seizure activity. The mechanism by which tranexamic acid acts as a proconvulsant involves a dose-dependent gamma-aminobutyric acid receptor (GABA) antagonism. Several studies have demonstrated an increased incidence of postoperative seizures in patients receiving high doses of tranexamic acid.