Intravenous tranexamic acid and intraoperative visualization during functional endoscopic sinus surgery: a...

Area of Science:

• Otolaryngology
• Surgical Innovation
• Pharmacology

Background:

• Intraoperative bleeding during endoscopic sinus surgery (ESS) can impede surgical progress and increase complication risks.
• Tranexamic acid, an antifibrinolytic, is recognized for its potential to mitigate operative bleeding.
• This study investigated the efficacy of intravenous tranexamic acid as an adjunct in ESS.

Purpose of the Study:

• To evaluate the impact of intravenous tranexamic acid on intraoperative bleeding during ESS.
• To assess the effect of tranexamic acid on the quality of the surgical field in ESS procedures.

Main Methods:

• A double-blind, randomized, controlled trial was conducted.
• Patients with chronic rhinosinusitis underwent ESS with either intravenous tranexamic acid or normal saline.
• Surgical field quality was assessed using the Wormald grading scale, and blood loss was estimated.

Main Results:

• Twenty-eight patients were included in the study.
• No statistically significant difference was observed in estimated blood loss (201 mL vs. 231 mL, p = 0.60).
• The Wormald surgical field score also showed no significant improvement (5.84 vs. 5.80, p = 0.93), with no adverse events reported.

Conclusions:

• Adjunctive intravenous tranexamic acid did not yield a clinically meaningful reduction in blood loss during ESS.
• The antifibrinolytic agent did not improve surgical field visualization in this patient cohort.
• Further research may be needed to explore alternative strategies for managing bleeding in ESS.