title: Comparison of two doses of tranexamic acid on bleeding and surgery site quality during sinus endoscopy surgery.
abstract: BACKGROUND
  One of the main concerns in sinus surgery is blood loss due to the high vasculature of the mucosa. Tranexamic acid (TA) is an antifibrinolytic agent which reduces bleeding following certain surgical procedures.
  
  
  METHODS
  This randomized double-blinded clinical trial was performed on 70 patients with class I and II ASA (American Society of Anesthesiologists) who were scheduled for endoscopic sinus surgery under general anesthesia. The average ages of the patients were 18 to 50 years old. Thirty-five patients (group A) received 5 mg/Kg of TA, and another 35 patients (group B) received 15 mg/Kg of TA. The mean arterial pressure (MAP), diastolic blood pressure (DBP), systolic blood pressure (SBP) and heart rate (HR) were documented. Also, the amount of blood loss and satisfaction scores were obtained from the surgeon in 30th, 60th, 90th, 120th and 180th minutes. All the data was analyzed by SPSS-15 software with T-test.
  
  
  RESULTS
  A total of 52 males and 18 females participated in the study. There were no significant differences between the mean age, MAP, DBP, SBP and HR during surgery between groups. Blood loss was 272.74 ± 25.77 mL 242.89 ± 51.77 mL in the group A and B respectively (P < 0.003). The surgeon was more satisfied with the surgical field of the group B than the group A (mean scores 4 (3-5) vs. 3 (1-5) respectively, P < 0.005). Surgery period and need for supplement drug to control bleeding in group B was significantly less than in group A (P < 0.05). But there was no significant difference between the two groups in terms of side effects.
  
  
  CONCLUSIONS
  Administration of 15 mg/Kg TA intravenously is more effective than 5 mg TA to achieve hemostasis and improving the quality of surgical field, surgeon satisfaction, less surgery period and bleeding volume during endoscopic sinus surgery without any significant side effects.
authors: Department of Anesthesiology, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
authors: Hamidreza
authors: H
authors: Abbasi
authors: Shekoufeh
authors: S
authors: Behdad
authors: Vida
authors: V
authors: Ayatollahi
authors: Naderali
authors: N
authors: Nazemian
authors: Parvaneh
authors: P
authors: Mirshamsi
mesh_terms: D000293:Adolescent; D000328:Adult; D000933:Antifibrinolytic Agents / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use*; D062186:Arterial Pressure / Q000187:drug effects; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D003971:Diastole / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000601:surgery*; D013599:Systole / Q000187:drug effects; D014148:Tranexamic Acid / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid