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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
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Does intravenous tranexamic acid reduce bleeding during mastoidectomy?

Samaneh Ziaei1, Saeid Sadeghi Joni2, Reza Shahriar3

  • 1DDS, MS. Assistant Professor, Dept. of Dral and Maxillofacial Medicine, Faculty of Dentistry, Sharekord Branch Shahrekord, Iran.

American Journal of Blood Research
|July 21, 2020
PubMed
Summary

Tranexamic acid significantly reduces bleeding during mastoidectomy, a crucial head and neck surgery. This improves surgical visualization and patient outcomes by minimizing blood loss.

Keywords:
Mastoidectomybleedingmicroscopic surgeriestranexamic acid

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Area of Science:

  • Otolaryngology
  • Surgical Hemostasis
  • Anesthesiology

Background:

  • Mastoidectomy is a vital head and neck surgical procedure often necessitated by otitis media complications.
  • Microscopic mastoidectomy demands a clear surgical field, which is frequently compromised by intraoperative bleeding.
  • Effective bleeding control is paramount for successful microscopic surgical outcomes.

Purpose of the Study:

  • To investigate the efficacy of tranexamic acid in mitigating blood loss during mastoidectomy.
  • To assess the impact of tranexamic acid on surgical visualization and patient hemodynamic parameters.

Main Methods:

  • A randomized clinical trial involving 69 patients undergoing mastoidectomy.
  • Patients were allocated to receive either tranexamic acid (10 mg/kg) or a normal saline placebo.
  • Data collected included bleeding volume, surgery duration, heart rate, and blood pressure.

Main Results:

  • Tranexamic acid administration was associated with a statistically significant reduction in bleeding during mastoidectomy (P<0.001).
  • A significant decrease in blood pressure was also observed in the tranexamic acid group.
  • No significant difference in surgery duration was noted between groups.

Conclusions:

  • Tranexamic acid is an effective agent for reducing intraoperative bleeding in mastoidectomy.
  • The use of tranexamic acid can enhance surgical field visualization for otolaryngologists.
  • Administering tranexamic acid is recommended for microscopic surgeries to improve outcomes.