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

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