A COMPARATIVE STUDY ON THE EFFECT OF TOPICAL PHENYLEPHRINE WITH TOPICAL TRANEXAMIC ACID IN MANAGEMENT OF EPISTAXIS

Epistaxis is defined as acute hemorrhage from the nostril, nasal cavity, or
nasopharynx. It is a frequent Emergency Department (ED) complaint and often causes significant
anxiety in patients and clinicians. Accordingly, this study aimed to compare the administration of topical
Phenylephrine with topical Tranexamic Acid (TXA) in management of epistaxis.
Materials & Methods: This double-blind, randomized clinical trial was conducted on 120 patients with
epistaxis referred to Imam-Khomeini University in Urmia, Iran. Patients who met the inclusion criteria,
were randomly allocated into two intervention and control groups. Sixty patients in the intervention
group received one pledget soaked with TXA for 10 minutes in each nasal cavity. Sixty patients in the
control group received Phenylephrine 0.5% with the same way. The cessation of bleeding in ED were
evaluated by 10 minutes after the administration of the above-mentioned drugs.
Results: Nasal hemorrhage was stopped in 17 out of 60 patients of control group received Phenylephrine
(28.3%) while in the intervention group received TXA, 40 out of 60 patients (66.7%) experienced the
cessation of their nosebleed that the difference was clinically and statistically significant (P<0.001).
Conclusion: According to study results, topical application of injectable form of TXA (500mg/5mL)
can be used as an ideal drug in management of epistaxis in prehospital and hospital settings and
subsequently leads to a reduction of extra costs and length of stay in the EDs