title: Does the preoperative administration of tranexamic acid reduce perioperative blood loss and transfusion requirements after head neck cancer surgery? A randomized, controlled trial.
abstract: BACKGROUND
  Head and neck cancer (HNC) surgery is associated with high intraoperative blood loss which may require urgent blood transfusion. Many strategies have been recommended to decrease the need for allogenic transfusion. Use of perioperative tranexamic acid (TA) has a promising role.
  
  
  OBJECTIVE
  This study was to evaluate the effectiveness of single preoperative bolus dose of TA on blood loss prevention and red blood cell transfusion in patients undergoing HNC surgery.
  
  
  METHODS
  A prospective, double-blind, and randomized controlled study.
  
  
  METHODS
  From 2007 July to 2010 January; 80 patients, aged (35-55), of American Society of Anesthesiologists II-III scheduled for unilateral HNC surgeries were randomly received either TA (Group T) in a dose of 20 mg/kg diluted to 25 cc with normal saline or an equivalent volume of normal saline (Group C) in a tertiary care hospital. Hemoglobin (Hb) concentration, platelet count, packed cell volume, fibrinogen level, D-dimer level were measured pre- and post-operatively.
  
  
  RESULTS
  Saline (C) Group required more blood, colloid, crystalloid for blood loss. In Group T, 32 patients did not require transfusion of any blood products compared to five patients in Group C (P < 0.0001) and only eight units of blood was transfused in Group T, whereas a total of 42 units of blood was transfused in Group C. Even after numerous transfusions, Hb% after 6 h and 24 h in Group C were significantly low in comparison with Group T (P < 0.05).
  
  
  CONCLUSIONS
  Thus, TA significantly reduces blood loss and chances of colloid, blood, and crystalloid transfusion caused by HNC surgery.
authors.affiliation: Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Berhampore, West Bengal, India.
authors.forename: Anjan
authors.initials: A
authors.lastname: Das
authors.affiliation: Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Berhampore, West Bengal, India.
authors.forename: Surajit
authors.initials: S
authors.lastname: Chattopadhyay
authors.affiliation: Department of Oral and Maxillofacial Surgery, Dr. R. Ahmed Dental College, Berhampore, West Bengal, India.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Mandal
authors.affiliation: Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Berhampore, West Bengal, India.
authors.forename: Subinay
authors.initials: S
authors.lastname: Chhaule
authors.affiliation: Department of Anaesthesiology, Murshidabad Medical College, Berhampore, West Bengal, India.
authors.forename: Tapobrata
authors.initials: T
authors.lastname: Mitra
authors.affiliation: Department of Anaesthesiology, N.R.S. Medical College, Kolkata, West Bengal, India.
authors.forename: Anindya
authors.initials: A
authors.lastname: Mukherjee
authors.affiliation: Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Berhampore, West Bengal, India.
authors.forename: Subrata Kumar
authors.initials: SK
authors.lastname: Mandal
authors.affiliation: Department of Gynecology and Obstetrics, College of Medicine and Sagore Dutta Hospital, Berhampore, West Bengal, India.
authors.forename: Sandip
authors.initials: S
authors.lastname: Chattopadhyay
keywords: Head neck cancer surgery; hemorrhage; tranexamic acid