Evaluation of Topical Tranexamic Acid on Intraoperative Bleeding in Endoscopic Sinus Surgery

Tranexamic acid (TA) is an antifibrinolytic agent which reduces bleeding following certain surgical procedures. The present study was performed on 56 patients, scheduled for elective endoscopic sinus surgery under general anesthesia, to examine the effects of topical TA on providing a bloodless surgical field and evaluate the bleeding volume. The study comprised 26 patients who received topical TA and 30 patients used placebo. The hemodynamic endpoints were to maintain the mean arterial blood pressure at 30% bellow its preoperative level. Intraoperative bleeding was assessed using a six point scale. There was less bleeding volume in the TA group than in the placebo group (174.0±10.6 vs 229.1±23.8 ml; P<0.05). The frequency of score 3 was 26% in TA group which was significantly lower than of placebo group (70%). The bleeding score of TA group was significantly lower than of placebo group (2.3±0.2 vs. 2.5±0.15). In conclusion it seems that topical application of tranexamic acid reduces intraoperative bleeding in endoscopic sinus surgery.