Local tranexamic acid in septoplastic surgery Evaluation of local tranexamic acid on septoplastic surgery quality

Hazrati, E and Kazemi Haki, B and Masnour Ghanaei, A.R and Soleimanlo, A and Rafiei, M.R (2021) Local tranexamic acid in septoplastic surgery Evaluation of local tranexamic acid on septoplastic surgery quality. Journal of Plastic, Reconstructive & Aesthetic Surgery. pp. 1-17.

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Abstract

Even the small amount of bleeding during nose surgery can impair the surgeon's vision, prolonged the duration of operation and affected on surgery quality therefore, various techniques have been proposed to control the bleeding. The aim of this study was to compare the efficacy of local use of tranexamic acid in the dry field of surgery. Method: This Randomized, double-blinded, controlled trial conducted in Operating room of Imam Reza Hospital, Tehran, Iran, from January 10, 2016, to February 8, 2017. sixty patients with age range of 20 to 60 years and the ASA physical status classes I candidates to septoplasty enrolled. Patients were randomized through white and black cards to receive either syringes. 30 patients in intervention group received lidocaine + adrenaline + tranexamic acid and 30 patients in control group received lidocaine + adrenaline. Bleeding volume measured by accumulated in the suction chamber and nasopharyngeal pack, and hemodynamic variations were measured. Surgeon’s satisfaction scores and suitability of operation field, were obtained from the surgeon by respectively Likert scale and Boezaart grading scale. Results: The intervention group had a higher score of surgeon satisfaction [4.1 vs 3.16 in control group (P= 0.001)] and fewer hemodynamic variations. The mean bleeding volume in the intervention was 187.23 ± 54.61 mL and in the control group was 341.22 ± 49.17 mL (P=0.001). The mean Boezaart score (suitability of operation field) in the intervention group was 1.8 (score range: 1-3) and in the control group was 2.53 (score range: 2-4) and it was statically significant (P= 0.001). Conclusion:The local use of tranexamic acid + lidocaine + adrenaline is associated with reduced bleeding, greater surgeon satisfaction, reduces the need for Karpol injection, and caused hemodynamic stability

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