title: Efficacy of Tranexamic Acid in Reducing Blood Loss during Maxillofacial Trauma Surgery-A Pilot Study.
abstract: OBJECTIVE
  Tranexamic acid (TXA) is prescribed for short term management of haemorrhage. It is also administered prophylatically in surgeries where blood loss is anticipated. Tranexamic mouth washes are also used in oral surgical procedures for patients with coagulopathies. The purpose of this study was to assess the efficiency of the usage of tranexamic acid on reduction of haemorrhage in maxillo mandibular trauma cases.
  
  
  METHODS
  Twelve consecutive male patients, between the ages 20-40 years, with multiple fractures of the facial bones, were included in this study. Six patients were administered either IV tranexamic acid (10 mg/kg- Group 1)and another six placebo (IV normal saline- Group 2) just before induction of anaesthesia. All patients were operated by the same surgical team, using the same standard techniques and the same anaesthetist and the same drugs were used during the surgery. Hypotension was induced for further reduction of intra operative blood loss. Intra and post-operative blood loss, operation time, transfusion of blood products, pre- and post-operative haemoglobin, number of days of hospitalisation and blood count were recorded for both groups.
  
  
  RESULTS
  Tranexamic acid significantly reduced the volume of blood loss during the surgery when compared with the control group (489.17± 106.7 mL vs 900.83 ± 113.7 mL). Considering the duration of operation and the treatment groups only, the mean total blood loss in the control group was 411.67 mL more than that in the tranexamic acid group. None of the patients of the TXA group required blood transfusion post-operatively. There was no difference in the length of hospital stay between the 2 groups. Two of the patients of the saline group required blood transfusion post-surgery due to significant drop in haemoglobin. The average drop in haemoglobin was 2 ± 1.4 in the tranexamic group and 4 ± 1.09 in the saline group.
  
  
  CONCLUSIONS
  Pre-operative intravenous bolus administration of tranexamic acid at 10 mg/kg reduces blood loss compared with placebo during the surgery.
authors.affiliation: Reader, Department of Oral and Maxillofacial Surgery, Sree Balaji Dental College and Hospital , Pallikaranai, Chennai, India .
authors.forename: Abu
authors.initials: A
authors.lastname: Dakir
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, Sree Balaji Dental College and Hospital , Pallikaranai, Chennai, India .
authors.forename: Balakrishnan
authors.initials: B
authors.lastname: Ramalingam
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, Sree Balaji Dental College and Hospital , Pallikaranai, Chennai, India .
authors.forename: Vijay
authors.initials: V
authors.lastname: Ebenezer
authors.affiliation: Reader, Department of Oral and Maxillofacial Surgery, Sree Balaji Dental College and Hospital , Pallikaranai, Chennai, India .
authors.forename: Prakash
authors.initials: P
authors.lastname: Dhanavelu
keywords: Haemorrhage; Normal saline (NS); Surgery; Tranexamic acid (TXA)