title: Effect of tranexamic acid irrigation on perioperative blood loss during orthognathic surgery: a double-blind, randomized controlled clinical trial.
abstract: OBJECTIVE
  Perioperative hemorrhage is an important concern during orthognathic surgery. The purpose of this study was to assess the effect of tranexamic acid (TXA) irrigation on perioperative hemorrhage during orthognathic surgery.
  
  
  METHODS
  In this double-blind, randomized controlled clinical trial, 56 participants who underwent orthognathic surgery were divided into 2 groups. The patients in the first group received TXA irrigation with normal saline (1 mg/mL), and the patients in the second group had normal saline for irrigation during orthognathic surgery. Age, gender, operation duration, the amount of irrigation solution used, and preoperative hemoglobin, hematocrit, and weight were the variables that were studied. The use of TXA solution for irrigation was the predictive factor of the study.
  
  
  RESULTS
  Each group consisted of 28 patients. Group 1 consisted of 15 male patients (53.6%) and 13 female patients (46.4%) and group 2 consisted of 14 male patients (50%) and 14 female patients (50%). There was no difference in the distributions of the variables between the 2 groups, except for the duration of the operation. The mean duration of the operation was 3.94 ± 0.61 hours in group 1 and 4.17 ± 0.98 hours in group 2, and the difference in this respect between the 2 groups was statistically significant (P < .05). The mean intraoperative blood loss was 817.85 ± 261.83 mL in group 1 and 575.00 ± 286.90 mL in group 2 (P < .05). The mean volume of irrigation was 1,057.14 ± 407.04 mL in group 1 and 843.57 ± 275.48 mL in group 2 (P > .05).
  
  
  CONCLUSIONS
  TXA is effective in reducing intraoperative blood loss in patients for whom substantial blood loss is anticipated.
authors.affiliation: Assistant Professor of Anesthesiology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Eftekharian
authors.affiliation: Postgraduate Student of Oral and Maxillofacial Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Ruhollah
authors.initials: R
authors.lastname: Vahedi
authors.affiliation: Postgraduate Student of Oral and Maxillofacial Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Tuba
authors.initials: T
authors.lastname: Karagah
authors.affiliation: Assistant Professor of Oral and Maxillofacial Surgery, Shahid Beheshti University of Medical Sciences, Shiraz, Iran. Electronic address: tabmed@gmail.com.
authors.forename: Reza
authors.initials: R
authors.lastname: Tabrizi
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006490:Hemostatics / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008313:Malocclusion, Angle Class III / Q000601:surgery; D063166:Maxillary Osteotomy / Q000379:methods; D061646:Operative Time; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods; D010919:Placebos; D012965:Sodium Chloride / Q000627:therapeutic use; D007507:Therapeutic Irrigation / Q000379:methods*; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D006490:Hemostatics; D010919:Placebos; D012965:Sodium Chloride; D014148:Tranexamic Acid