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The Effect of Tranexamic Acid Local Injection on Bleeding during and after Tonsillectomy: A Double-Blind Randomized
Mojtaba Abtahi1, Amir-Abbas Kargoshai1, Hamidreza Shetabi2
1Department of Otorhinolaryngology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
World Journal of Plastic Surgery
|January 16, 2024
Summary
Local injection of tranexamic acid (TXA) did not reduce bleeding during or after tonsillectomy compared to placebo. While surgeon satisfaction improved with TXA, it did not significantly impact bleeding control or surgery duration.
Area of Science:
- Otolaryngology
- Surgical Hemostasis
- Pharmacology
Background:
- Tonsillectomy is a common procedure with a risk of significant bleeding.
- Post-tonsillectomy hemorrhage is a serious complication requiring medical attention.
Purpose of the Study:
- To evaluate the efficacy of local tranexamic acid (TXA) injection in reducing bleeding during and after tonsillectomy.
- To assess the impact of TXA on surgeon satisfaction, hemodynamic stability, and rebleeding rates.
Main Methods:
- A double-blind, randomized placebo-controlled trial was conducted with 20 tonsillectomy patients.
- TXA was administered locally to one side, with placebo to the contralateral side, 10 minutes before surgery.
- Blood loss, surgeon satisfaction, hemodynamic parameters (HR, MAP), and rebleeding were primary and secondary outcomes.
Main Results:
- No significant difference in blood loss volume between TXA and placebo groups.
- Surgeon satisfaction was significantly higher in the TXA group (p<0.05).
- No significant differences in surgery duration, heart rate, mean arterial pressure, or rebleeding rates were observed.
Conclusions:
- Local TXA injection did not demonstrate superiority over placebo for controlling bleeding during or after tonsillectomy.
- TXA improved surgeon satisfaction but did not reduce surgical duration or prevent complications like rebleeding.
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