title: Effect of topical tranexamic acid on bleeding and quality of surgical field during functional endoscopic sinus surgery in patients with chronic rhinosinusitis: a triple blind randomized clinical trial.
abstract: BACKGROUND
  The effect of tranexamic acid (TXA) on bleeding and improvement of surgical field during functional endoscopic sinus surgery (FESS) is not clear yet. This study was conducted to answer this question.
  
  
  METHODS
  This trial was conducted on 60 patients with chronic sinusitis at Beasat Hospital, Hamadan, Iran, from April to November 2013. Thirty patients in the intervention group received three pledgets soaked with TXA 5% and phenylephrine 0.5% for 10 minutes in each nasal cavity before surgery. Thirty patients in the control group received phenylephrine 0.5% with the same way. The amount of bleeding and the quality of surgical field were evaluated at 15, 30, and 45 minutes after the start of surgery using Boezaart grading.
  
  
  RESULTS
  The quality of the surgical field in the intervention group compared to the control group was significantly better in the first quarter (P = 0.002) and the second quarter (P = 0.003) but not in the third quarter (P = 0.163). Furthermore, the amount of bleeding was much less during all periods in the intervention group than in the control group (P = 0.001).
  
  
  CONCLUSIONS
  Topical TXA can efficiently reduce bleeding and improve the surgical field in FESS in patients with rhinosinusitis. Based on these findings, topical TXA may be a useful method for providing a suitable surgical field during the first 30 minutes after use.
  
  
  BACKGROUND
  Iranian Registry of Clinical Trials IRCT201212139014N15.
authors.affiliation: Department of Ear-Nose-Throat Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Javaneh
authors.initials: J
authors.lastname: Jahanshahi
authors.affiliation: Department of Ear-Nose-Throat Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Farnaz
authors.initials: F
authors.lastname: Hashemian
authors.affiliation: Department of Ear-Nose-Throat Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Pazira
authors.affiliation: Department of Anesthesiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Bakhshaei
authors.affiliation: Department of Ear-Nose-Throat Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Farahani
authors.affiliation: Department of Ear-Nose-Throat Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Ruholah
authors.initials: R
authors.lastname: Abasi
authors.affiliation: Modeling of Noncommunicable Diseases Research Center, Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Jalal
authors.initials: J
authors.lastname: Poorolajal
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D004724:Endoscopy; D004844:Epistaxis / Q000517:prevention & control; D005260:Female; D006488:Hemostasis, Surgical; D006801:Humans; D008297:Male; D008875:Middle Aged; D010656:Phenylephrine / Q000627:therapeutic use; D012220:Rhinitis / Q000601:surgery*; D012852:Sinusitis / Q000601:surgery*; D014148:Tranexamic Acid / Q000008:administration & dosage*; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000933:Antifibrinolytic Agents; D014662:Vasoconstrictor Agents; D010656:Phenylephrine; D014148:Tranexamic Acid