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Published on: November 6, 2019
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Perioperative tranexamic acid in day-case paediatric tonsillectomy.
1Epsom and St Helier University Hospitals NHS Trust, UK.
Summary
Perioperative tranexamic acid may reduce primary bleeding after pediatric tonsillectomy, allowing same-day discharge. This study found a 0.4% bleeding rate, significantly lower than the expected 1% for this procedure.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Pharmacology
Background:
- Tranexamic acid is used to minimize blood loss in surgery and trauma.
- Primary hemorrhage rates after pediatric tonsillectomy are a concern, impacting day-case management.
- Previous studies show reduced blood loss but not primary hemorrhage rates with tranexamic acid.
Purpose of the Study:
- To evaluate the incidence of primary hemorrhage following pediatric tonsillectomy with perioperative tranexamic acid.
- To assess the potential of tranexamic acid to facilitate day surgery for pediatric tonsillectomy.
Main Methods:
- Retrospective review of 476 children (ages 3-16) undergoing Coblation™ tonsillectomy.
- Children received intravenous tranexamic acid (10-15 mg/kg) during anesthesia.
- Data collected on bleeding within 24 hours post-surgery.
Main Results:
- Two children (0.4%) experienced minor bleeding within two hours of surgery.
- Both cases were managed with hemostasis and same-day discharge.
- The observed hemorrhage rate was lower than the UK expected rate of 1% for this technique.
Conclusions:
- Single-dose perioperative tranexamic acid may decrease primary hemorrhage after pediatric tonsillectomy.
- This could enable more same-day discharges for pediatric tonsillectomy procedures.
- Further large-scale, prospective, randomized controlled trials are warranted to confirm these findings.
