Surgical treatment is indicated for hip dislocation in patients with cerebral palsy (CP), but it requires care due to the state of nutrition and associated clinical comorbidities. The use of resources that minimize blood loss and the need for blood transfusions are essential to avoid complications. Tranexamic acid (TXA) has been highlighted for orthopedic surgeries to control intraoperative bleeding; however, there is a lack of large studies for its use in hip surgeries in patients with CP. This study aims to evaluate the efficacy and safety of tranexamic acid to reduce bleeding in pediatric patients with cerebral palsy undergoing surgical treatment for hip instability. A sample of 31 patients with CP who underwent surgical treatment for hip dislocation (hip adductor stretching, varization osteotomy of the proximal femur and acetabuloplasty using the Dega technique) was randomly divided into groups: control (n = 10) and TXA (n = 21). Preoperative and 24 h hemoglobin concentrations, the length of hospital stay (LHS), and intraoperative bleeding (IB) were analyzed. TXA significantly reduced the IB (p = 0.02). The variance in hemoglobin concentration was lower for the TXA group, but without statistical significance (p = 0.06). There was no difference in LHS. Also, no statistical difference was observed for the number of transfusions (p = 0.08). The findings provide evidence of the effectiveness of TXA in decreasing intraoperative bleeding and its safety for use in pediatric patients with cerebral palsy.

The aim of the study was to characterize the heart rate variability in a patient with no comorbidities, submitted to buccomaxillofacial surgery under total venous anesthesia using the linear frequency and nonlinear methods in the chaos domain (Poincaré plot). Data collection was performed before, during and after the surgical procedure using a Polar V800 cardiofrequencymeter and subsequently analyzed and filtered using the Kumbios HRV 3.0 software. During propofol infusion, elevations in LF, HF, SD1 and SD2 were observed. The LF/HF ratio showed obvious changes, which were found to be maximal during extubation and submaximal during awakening under greater influence of the sympathetic nervous system. The moment of the incision has parameters similar to those of rest. Final surgery maintenance showed the lowest values of LH/HF and SD1/SD2, with lower LF and SD2 values compared to rest. During the awakening, there was a decrease in SD1 and HF, representing the moment of greatest fragility during the total venous anesthesia, being of fundamental importance future studies about their repercussions.