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The Effect of Topical Tranexamic Acid on Bleeding Reduction during Functional Endoscopic Sinus Surgery
Mohammad Hossein Baradaranfar1, Mohammad Hossein Dadgarnia1, Hossein Mahmoudi1
1Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Iranian Journal of Otorhinolaryngology
|April 11, 2017
Summary
Topical tranexamic acid did not significantly reduce bleeding during functional endoscopic sinus surgery (FESS). Further research is needed to explore alternative methods for controlling intraoperative blood loss in FESS procedures.
Area of Science:
- Otolaryngology
- Surgical Hemostasis
- Pharmacology
Background:
- Intraoperative bleeding during functional endoscopic sinus surgery (FESS) poses risks by obscuring the surgical field.
- Effective methods to control bleeding are crucial for patient safety and surgical outcomes.
Purpose of the Study:
- To evaluate the efficacy of topical tranexamic acid in minimizing intraoperative bleeding during FESS.
- To assess the impact of tranexamic acid on surgical field quality and surgeon satisfaction.
Main Methods:
- A double-blind, randomized clinical trial involving 60 patients with chronic rhinosinusitis with polyposis undergoing FESS.
- Patients received either tranexamic acid (2 g in 400 mL saline) or a saline placebo for irrigation and suctioning.
- Intraoperative blood loss and surgical field quality (Boezzart's scale) were primary outcome measures.
Main Results:
- No statistically significant difference in mean blood loss was observed between the tranexamic acid group (235.6 mL) and the saline group (254.13 mL) (P=0.31).
- Surgical field quality, surgeon satisfaction, and surgery duration did not differ significantly between the groups.
Conclusions:
- Topical tranexamic acid, administered via irrigation, did not effectively reduce intraoperative bleeding or improve the surgical field during FESS.
- Further investigation is recommended with larger sample sizes, higher drug concentrations, and alternative administration methods like spraying or pledgets.