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Comparative study of the effect of administering two doses of tranexamic acid in patients undergoing
Amir Shafa1, Shima Besharati2, Hamidreza Shetebi1
1Anesthesiology Department, Isfahan University of Medical Sciences Isfahan, Iran.
Background:
Adenotonsillectomy is a safe and common operation to remove adenoids and tonsils. Here we decided to compare the two dosages of tranexamic acid and their effects on hemodynamic changes and anesthesia-related indexes during surgical interventions.
Methods:
This is a double-blinded clinical trial performed in 2019-2020 on 64 children who were candidates for adenotonsillectomy. The patients were randomly divided into two groups of 32 based on the table of random numbers. Group A received 5 mg/kg slowly tranexamic acid for 10 minutes and group B received 10 mg/kg tranexamic acid slowly for 10 minutes. The study protocol was approved by the Research committee of Isfahan University of Medical Sciences and the Ethics Committee has confirmed it (Ethics code: IR.MUI.MED.REC.1398.639) (Iranian Registry of Clinical Trials (IRCT) code: IRCT20171030037093N33, https://en.irct.ir/trial/46553).
Results:
The mean volume of intraoperative bleeding in children in group A is significantly higher than in children in group B (P < 0.05). However, no significant difference was observed between the length of stay in recovery and the duration of extubation and the mean dose of propofol in the two groups (P > 0.05). The mean arterial oxygen saturation of children in both groups increased significantly over time (P < 0.05). However, no significant difference was observed between the two groups (P > 0.05). According to the results, the mean HR in both groups decreased significantly over time (P < 0.05). In addition, the mean HR in children in the group B was significantly lower than children in the group A (P < 0.05).
Conclusion:
Administration of 10 mg/kg of tranexamic acid during tonsillectomy is associated with lower amounts of bleeding and lower heart rate than 5 mg/kg dosage. These results were in line with most previous studies.
Insights
A higher dose of tranexamic acid (10 mg/kg) significantly reduced intraoperative bleeding and heart rate in children undergoing adenotonsillectomy compared to a lower dose (5 mg/kg). This finding supports its use in pediatric tonsillectomy.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Adenotonsillectomy is a common pediatric surgical procedure.
- Controlling intraoperative bleeding and hemodynamic stability is crucial.
- Tranexamic acid is used to reduce bleeding during surgeries.
Purpose of the Study:
- To compare the efficacy of two different dosages of tranexamic acid (5 mg/kg vs. 10 mg/kg).
- To evaluate the effects of these dosages on hemodynamic changes and anesthesia-related indexes during adenotonsillectomy in children.
Main Methods:
- A double-blinded clinical trial involving 64 children undergoing adenotonsillectomy.
- Patients were randomized into two groups: Group A (5 mg/kg tranexamic acid) and Group B (10 mg/kg tranexamic acid).
- Hemodynamic parameters and anesthesia-related indexes were monitored.
Main Results:
- Group B (10 mg/kg) showed significantly lower mean intraoperative bleeding compared to Group A (5 mg/kg).
- Mean heart rate was significantly lower in Group B than in Group A.
- No significant differences were observed in recovery stay, extubation duration, or propofol dosage between groups.
Conclusions:
- The 10 mg/kg dosage of tranexamic acid is more effective in reducing intraoperative bleeding and heart rate during pediatric adenotonsillectomy than the 5 mg/kg dosage.
- This higher dosage offers a potential benefit for improving surgical outcomes in this patient population.
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