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Effects of tranexamic acid during endoscopic sinsus surgery in children
Ahmed A Eldaba1, Yasser Mohamed Amr, Osama A Albirmawy
1Department of Anesthesia and Surgical Intensive Care, Tanta University, Tanta, Egypt.
Insights
Tranexamic acid (TA) significantly reduces intra-operative bleeding and surgery duration in children undergoing functional endoscopic sinus surgery (FESS). This study demonstrates TA
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Pharmacology
Background:
- Functional endoscopic sinus surgery (FESS) in children can involve significant intra-operative bleeding, potentially complicating the procedure.
- Optimizing surgical field visualization and minimizing blood loss are critical for successful pediatric FESS outcomes.
Purpose of the Study:
- To evaluate the efficacy of a single intravenous dose of tranexamic acid (TA) in reducing intra-operative bleeding during FESS in pediatric patients.
- To assess the impact of TA on surgical field quality and procedure duration in this population.
Main Methods:
- A randomized controlled trial involving 100 children undergoing FESS.
- Participants were randomized to receive either intravenous tranexamic acid (25 mg/kg) or a saline placebo just after induction.
- Intra-operative parameters including blood pressure, heart rate, surgical field quality, bleeding volume, and procedure duration were recorded and compared between groups.
Main Results:
- Significantly improved surgical field quality was observed in the tranexamic acid group at both 15 and 30 minutes post-administration (P<0.006 and P<0.004, respectively).
- The tranexamic acid group exhibited a statistically significant reduction in both the volume of intra-operative bleeding and the duration of surgery compared to the placebo group (P<0.0001).
- Fewer patients in the TA group experienced moderate bleeding compared to the placebo group.
Conclusions:
- A single intravenous bolus dose of tranexamic acid is effective in improving surgical field quality during pediatric FESS.
- Tranexamic acid administration leads to reduced intra-operative bleeding and shorter surgical times in children undergoing FESS.
- This intervention offers a valuable strategy for enhancing safety and efficiency in pediatric FESS procedures.
Objectives:
This study was conducted to evaluate the effect of tranexamic acid (TA) on the intra-operative bleeding during the functional endoscopic sinus surgery (FESS) in children.
Methods:
A total of 100 children recruited to undergo FESS were randomized into two groups. Group I: Was given just after induction, intra-venous 25 mg/kg TA diluted in 10 ml of normal saline. Group II: Was given 10 ml of normal saline. Non-invasive blood pressure, heart rate, and quality of the surgical field were estimated every 15 min. Volume of bleeding and duration of the surgical procedure were recorded.
Results:
Surgical field quality after 15 min revealed that seven patients in group I had minimal bleeding versus no one in group II, P=0.006. Meanwhile, 35 patients in group I had mild bleeding versus 26 patients in group II, P=0.064. Higher number of patients in group II than in group I had moderate bleeding, P=0006. Also, at 30 min, revealed that 10 patients in group I had minimal bleeding versus one patient in group II, P=0.004. Meanwhile, 37 patients in group I had mild bleeding versus 28 patients in group II, P=0.059. Higher number of patients in group II than in group I had moderate bleeding, P<0001. Duration of the surgeries and volume of bleeding were significantly less in tranexamic group than the placebo group, P<0.0001.
Conclusion:
Single intra-venous bolus dose of tranexamic in children during the FESS improves quality of surgical field, reduces intra-operative bleeding, and duration of surgery.
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