پزشکی بالینی ابن سینا (Sep 2018)
Evaluation of Intravenous Tranexamic Acid on Hemorrhage Volume and Quality of Surgery Field during Nasal Surgery
Abstract
Background and Objective: Bleeding is one of the most common problem during nasal surgeries, including the functional and aesthetic surgeries. One of the methods to reduce intraoperative hemorrhage is the administration of anti-fibrinolytic agents, such as tranexamic acid. Regarding this, the present study aimed to determine the effect of intravenous transaxamic acid on bleeding volume and operative field quality during nasal surgery. Materials and Methods: This clinical trial was conducted on 70 patients within the age range of 18-65 years referring to Besat Hospital in Hamadan, Iran, for nasal surgery. The participants were assigned into two groups of case (n=35) and control (n=35) using the table of random numbers. The case group was administered a mixture of 500 mg tranexamic acid and 500 ml ringer serum infused with a maximum rate of 15 mg/min at a concentration of 1 mg/ml. However, the control group just received ringer serum infusion. Results: The mean age of the patients was 34.64±15.43 years and 61.4% of them were male. There was no statistically significant difference between the two groups in terms of age, gender, and weight (P>0.05). The mean scores of surgeon satisfaction were obtained as 73.6 and 51.4 in the case and control groups, respectively, which were significantly different between the two groups (P=0.000). The mean volumes of blood in suction were 208±97.64 and 273.71±147.72 ml in the case and control groups, respectively, which showed a significant difference between the groups (P=0.032). Furthermore, the mean surgery durations were estimated as 119.2±34.58 and 139.71±38.46 min in the case and control groups, respectively, and this difference was statistically significant (P=0.02). Additionally, the mean volumes of infused fluid were 1057.14±217.31 and 1260±497.168 ml in the case and control groups, respectively, which were significantly different between the two groups (P=0.030). The mean difference of hematocrit level between the pre- and post-surgical stages were obtained as 1.67% and 3.13% in the case and control groups, respectively, which were significantly different between the study groups (P=0.001). No tranexamic acid side effects were observed in the patients. Conclusion: According to our study, the intravenous infusion of tranexamic acid could reduce hemorrhage and improve the quality of nasal surgery field without any significant side effects.
