The effect of intravenous tranexamic acid on blood loss and surgical field quality during endoscopic sinus surgery: a placebo-controlled clinical trial

Study Objectives: To evaluate the effects of intravenous (IV) tranexamic acid on blood loss and surgical field quality during functional endoscopic sinus surgery (FESS). Design: Randomized, double-blinded, controlled trial. Setting: Operating room and postoperative recovery area of a university-affiliated hospital. Patients: 84 consecutive, adult, ASA physical status 1 and 2 patients undergoing FESS. Interventions: Patients were randomized to receive either IV tranexamic acid 10 mg/kg (TA group) or sterile water 0.1 mL/kg (placebo group) as a bolus dose immediately after induction of anesthesia. Measurements: Amount of blood loss and bleeding and satisfaction scores were obtained from the surgeon. Main Results: Blood loss in the TA group was 184 +/- 64 mL and in the placebo group, 312 +/- 75 mL on average (P<0.01). The median (range) bleeding score in the TA group was significantly lower than the placebo group [2 (1-3) vs 2.5 (2-4); P<0.0001]. The surgeon was more satisfied with the surgical field in the TA group than the placebo group [median score: 4 (3-5) vs 3 (1-5), P<0.001]. Conclusion: Intravenous tranexamic acid effectively reduces bleeding and improves the surgical field during FESS. (C) 2011 Elsevier Inc. All rights reserved.