title: Evaluation of the efficacy of tranexamic acid on blood loss in orthognathic surgery. A prospective, randomized clinical study.
abstract: The purpose of this prospective, randomized, double blind study was to assess the effect of tranexamic acid on blood loss, quality of surgical field and duration of surgery in adolescent orthognathic surgery patients. 50 consecutive patients, scheduled for orthognathic surgery were included. The study group (n=25) received tranexamic acid 10mg/kg as a bolus preoperatively followed by 1mg/kg as a maintenance dose intra operatively; the control group (n=25) received placebo (normal saline). All patients received moderate hypotensive anaesthesia with nitroglycerin and had surgery according to a standard protocol. Intra operative blood loss, duration of surgery, quality of surgical field, blood transfusion and complications, if any, were recorded. The mean total blood loss was 166.1±65.49ml in the study group and 256.4±77.80ml in the control group. The results showed statistically significant reduction in blood loss (p<0.001) and improved quality of surgical field (p<0.001) in the study group. There was no significant difference in duration of surgery and transfusion requirements between the two groups. In conclusion, preoperative and intra operative administration of the antifibrinolytic agent, tranexamic acid, is effective in controlling blood loss and improving the quality of the surgical field.
authors.affiliation: Department of OMFS, Ragas Dental College and Hospital, India. sankar_4@yahoo.com
authors.forename: Duraiswamy
authors.initials: D
authors.lastname: Sankar
authors.forename: Radhika
authors.initials: R
authors.lastname: Krishnan
authors.forename: M
authors.initials: M
authors.lastname: Veerabahu
authors.forename: B
authors.initials: B
authors.lastname: Vikraman
mesh_terms: D000293:Adolescent; D000328:Adult; D000771:Anesthesia, Intravenous / Q000379:methods; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D001810:Blood Volume; D004311:Double-Blind Method; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007023:Hypotension, Controlled; D008297:Male; D016343:Monitoring, Intraoperative; D005996:Nitroglycerin / Q000627:therapeutic use; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D010919:Placebos; D011446:Prospective Studies; D013997:Time Factors; D014148:Tranexamic Acid / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D010919:Placebos; D014665:Vasodilator Agents; D014148:Tranexamic Acid; D005996:Nitroglycerin