The Effect of Topical Tranexamic Acid on Bleeding Reduction during Functional Endoscopic Sinus Surgery
Author(s):
Abstract:
Introduction
Bleeding is a common concern during functional endoscopic sinus surgery (FESS) that can increase the risk of damage to adjacent vital elements by reducing the surgeons field of view. This study aimed to explore the efficacy of topical tranexamic acid in reducing intraoperative bleeding.Materials And Methods
This double-blind, randomized clinical trial was conducted in 60 patients with chronic rhinosinusitis with polyposis (CRSwP) who underwent FESS. Patients were randomly divided into two groups; tranexamic or salinetreatment. During surgery, normal saline (400 mL) or tranexamic acid (2 g) in normal saline with a total volume of 400 mL were used in the saline and tranexamic groups, respectively, for irrigation and suctioning. The surgeons assessment of field of view during surgery and intraoperative blood loss were recorded.Results
Mean blood loss was 254.13 mL in the saline group and 235.6 mL in the tranexamic group (P=0.31). No statistically significant differences between the two groups were found in terms of other investigated variables, such as surgical field quality based on Boezzarts scale (P=0.30), surgeon satisfaction based on a Likert scale (P=0.54), or duration of surgery (P=0.22).Conclusion
Use of tranexamic acid (2 g in 400 mL normal saline) through washing of the nasal mucosa during FESS did not significantly reduce blood loss or improve the surgical field of view. Further studies with larger sample sizes and higher drug concentrations, and using other methods of administration, such as spraying or applying pledgets soaked in tranexamic acid, are recommended. Keywords:
Bleeding , Rhinosinusitis , Polyposis , Tranexamic acid , Topical , Sinus , Surgery
Language:
English
Published:
Iranian Journal of Otorhinolaryngology, Volume:29 Issue: 2, Mar 2017
Pages:
69 to 74
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