Soudabeh Haddadi, Arman Parvizi, Alireza Fadaee Naiini, Zahra Atkar Roshan, Sakineh Arghand, Bahram Naderi Nabi,
Volume 6, Issue 1 (4-2015)
Abstract
Abstract:
Aims and Background: Tranexamic acid has been used to reduce blood loss and the need for blood transfusion in many surgeries. Traumatic mandibular surgeries can be associated with significant bleeding which affects the field of operation and creates difficulties for the surgeon. Therefore we decided to evaluate the effect of tranexamic acid on the amount of bleeding during traumatic mandibular surgeries.
Methods and Materials: In this randomized double blinded clinical trail, 90 patients, scheduled for traumatic mandibular surgeries with ASA class I-II and aged between 18 to 40 years, were included. They were randomly assigned to each group (n=45). After induction of general anesthesia with the same plan they received tranexamic acid (10mg/kg) or equal volume of normal saline, intravenously. Intra operative bleeding, pre-op hemoglobin (Hb), hematocrit (Hct) concentration, post-op (after 6 hours) Hb and Hct concentration, rate of blood transfusion and the quality of surgical field were recorded for each patient. Then data analyisis was performed with (SPSS software version 16).
Findings: Mean intraoperative bleeding in the tranexamic acid and placebo group were 80.44± 49.43ml and 183.0 ± 69.53ml, respectively (P=0.0001). Post-op decreasing rate of Hb and Hct were less in the tranexamic acid group vs. the control one(P=0.0001 for Hb , P=0.001 for Hct). The Quality of surgical field leading to the surgeon’s satisfaction was better in the tranexamic group than the control group. (P=0.0001). None of the patients needed blood transfusion. Adverse effects were not seen in any of the groups.
Conclusions: Administration of IV tranexamic acid decreases the amount of bleeding during mandibular surgeries.
Keywords: Tranexamic acid, Bleeding, Mandibular surgery, Hemoglobin, Hematocrit
Samira Berenjian, Valiollah Hassani, Mohamad Farhadi, Behrooz Zaman, Mahzad Alimian,
Volume 7, Issue 4 (1-2017)
Abstract
Aims and Background: Bleeding during rhinoplasty is a complication that decreases the surgeon’s vision and even
causes more side effects. Different methods have been proposed to reduce bleeding during otorhinolaryngology
surgeries. The aim of this study is to compare the effect of tranexamic acid (TXA) and Dexmedetomidine (DEX)
on the amount of bleeding in patients candidate for rhinoplasty.
Materials and methods: In this randomized double-blind clinical trial, 76 patients who were candidate for
elective rhinoplasty surgery entered the study. The first group received 10 mg/kg Tranexamic acid (TXA), and
the second group received 1 μg/kg Dexmedetomidine (DEX) intravenously within 15 minutes immediately after
induction. Bleeding volume, hemodynamic parameters and surgeon’s satisfaction were evaluated.
Findings: The amount of intra-operative bleeding was 145.2±22.1 ml in DEX group and 141.8±24.1 ml in TXA
group (p=0.46). The mean score of surgeon’s satisfaction was 1.65±0.53 in DEX group and 1.42±0.64 in TXA
group (p=0.089).
Conclusions: Totally the efficacy of DEX and TXA was equal. TXA reduces bleeding in major surgeries but for
rhinoplasty, in which bleeding volume is not so much perhaps using DEX is a better option.
Shideh Marzban, Soudabeh Haddadi, Zahra Asad Zadeh, Zahra Atrkar Roshan, Ali Faghih, Arman Parvizi,
Volume 8, Issue 2 (7-2017)
Abstract
Aim and background: Intra operative bleeding is an inevitable complication of endoscopic sinus surgery (ESS), besides it is worring for both anesthesiologist and otolaryngologist. The aim of this study was the survey of relationship between tranexamic acid (TA) dose and the amount of bleeding and duration of surgery in patients with chronic rhinosinusitis. Methods and Materials: This randomized double-blinded clinical trial was performed on 100 patients with class I and II ASA )American Society of Anesthesiologists( who were scheduled for endoscopic sinus surgery under general anesthesia.50 patients )groupL( received 5 mg/kg of TA, and another 50 patients )groupH( received 10 mg/ kg of TA after tracheal intubation. Anesthesia plan was the same in both groups.Intra operative bleeding, systolic and diastolic blood pressure(BP), and heart rate (HR) at 15th, 30th, 60th, 120th, 150th minutes, surgeon satisfaction rate, duration of surgery, and complications were documented. Data was analyzed by SPSS-19 software. Findings: Statatistical analysis showed that there was no significant difference considering demographic data between the groups.Surgical time was not significantly different between the groups (p=0.83), but the mean blood loss amount based on mililiter and the percent of maximal allowable blood loss (MABL) were less in group H.And the surgical field was better in group H. Conclusions: In this study it was shown that administration of 10 mg/kg TA intravenously has been effective to achieve less blood loss, and to improve the quality of surgical field during endoscopic sinus surgery without any significant side effects.
