The effect of tranexamic acid (cyclokapron) on blood loss after third molar extraction under a day case general anaesthetic.
OBJECTIVE
To evaluate the effect of pre-operative administration of tranexamic acid in preventing prolonged post-operative bleeding in day-case patients. Day-case admission is highly appropriate for dentoalveolar surgery but one of the problems is prolonged post-operative haemorrhage which at times may delay discharge or necessitate readmission to hospital. Tranexamic acid has traditionally been used to treat post-operative bleeding.


METHODS
A prospective double-blind randomised study.


METHODS
Eastman Dental Hospital, London.


METHODS
Fifty-six patients were consecutively selected from healthy adult volunteers who were having third molar extraction in the day case unit of the Eastman Dental Hospital over a period of 22 weeks. Tranexamic acid (25 mg/kg) or normal saline was administered intravenously at induction by the anaesthetist and blood loss was measured intra- and post-operatively.


RESULTS
A significant reduction (P = 0.023) in the post-operative blood loss was found in the tranexamic acid group. However, there was no significant difference in the intra-operative (P = 0.4) and the overall total blood loss (P = 0.21). No patient receiving tranexamic acid required readmission to control prolonged bleeding, or suffered any side effects from the drug.


CONCLUSIONS
This study has shown that one intravenous pre-operative dose of tranexamic acid is effective in preventing excessive post-operative bleeding in patients undergoing third molar extraction under a day case general anaesthetic and therefore facilitates safe discharge from hospital.
Senghore
N
N
Department of Oral and Maxillofacial Surgery, Eastman Dental Institute and Hospital, London.
Harris
M
M
D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects*; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011292:Premedication; D011446:Prospective Studies; D014081:Tooth Extraction / Q000009:adverse effects*; D014148:Tranexamic Acid / Q000008:administration & dosage*
D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid