Reducing blood loss during open myomectomy with intravenous versus topical tranexamic acid: A double-blinded randomized placebo-controlled trial

Abstract

Objectives: To assess the effect of Intravenous versus Topical Tranexamic acid in reducing intra-operative and post-operative blood loss in abdominal myomectomy surgeries. Materials and methods: In a randomized double-blind placebo-controlled trial, 105 women undergoing abdominal myomectomy for symptomatic uterine leiomyomas were randomly assigned to three groups: group 1 [35 patients received 110 ml normal saline IV just before skin insion], group 2 [35 patients received 1 g tranexamic acid (2 ampoules of kapron 500 mg 5 ml Amoun company) IV just before skin in scion] and group 3 [35 patients received 2 g topical tranexamic acid (4 ampoules of kapron 500 mg 5 ml) applied on myoma bed after myomectomy]. The primary outcome was intra-operative, postoperative and all blood loss estimation. Results: Both Group II (IV tranexamic acid) and Group III (topical tranexamic acid application) showed great reduction in intraoperative and post-operative blood loss (blood in the intraabdominal drain) compared with Group I (placebo group), (P = .0001, 0.0001, 0.0001, 0.0001), so the overall estimated blood loss in group II and III showed highly reduction compared with group I (P = .0001, .0001). Conclusion: Intravenous and Topical Tranexamic acid application safe and reliable method to help decrease blood loss during and after open myomectomy. Keywords: Tranexamic acid, Myomectomy