Efficacy of tranexamic acid on side effects of rhinoplasty: A randomized double-blind study

The aim of this randomized double-blind study was to evaluate the efficacy of Tranexamic acid (TXA) on intraoperative bleeding, postoperative eyelid edema, and postoperative periorbital ecchymosis in rhinoplasty.

Sixty rhinoplasty patients who needed hump reduction and lateral osteotomy were included and then randomly assigned into two groups. In the intervention group (n = 30), 10 mg/kg of TXA was administered prior to the operation and in the control group, the patients were given 20 mL of normal saline. Intraoperative bleeding was evaluated by gravimetric method and pre and postoperative hemoglobin and hematocrit levels were determined. Eyelid edema and periorbital ecchymosis were evaluated using 0-4 points scoring system. Surgeon satisfaction was measured by asking questions of the surgeon. Data were analyzed by SPSS 20.0 (P < 0.05).

In total, 10 participants were excluded from the research, and 50 patients were included in the study. Mean (SD) of intraoperative bleeding was 213 (65) mL and 254 (55) mL in the intervention and control group, respectively, based on the clinical methods (P = 0.013). Level of hemoglobin was 266.69 in the control group versus 241.25 in the TXA group, indicating that this effect on the intraoperative bleeding was not significant (P = 0.1). Hematocrit differences before and after operation were significant (P = 0.03) (247.06 mL in TXA vs. 279.2 mL in the control group). TXA had a statistically significant effect on the eyelid edema (P = 0.03), periorbital ecchymosis (P = 0.04), and surgeon satisfaction (P = 0.03).

Administration of 10 mm/kg TXA had a significant effect in decreasing the intraoperative bleeding rate, eyelid edema, and periorbital ecchymosis in the rhinoplasty with minimal side effects.