title: The Effect of Topical Tranexamic Acid on Bleeding Reduction during Functional Endoscopic Sinus Surgery.
abstract: BACKGROUND
  Bleeding is a common concern during functional endoscopic sinus surgery (FESS) that can increase the risk of damage to adjacent vital elements by reducing the surgeon's field of view. This study aimed to explore the efficacy of topical tranexamic acid in reducing intraoperative bleeding.
  
  
  METHODS
  This double-blind, randomized clinical trial was conducted in 60 patients with chronic rhinosinusitis with polyposis (CRSwP) who underwent FESS. Patients were randomly divided into two groups; tranexamic or saline treatment. During surgery, normal saline (400 mL) or tranexamic acid (2 g) in normal saline with a total volume of 400 mL were used in the saline and tranexamic groups, respectively, for irrigation and suctioning. The surgeons' assessment of field of view during surgery and intraoperative blood loss were recorded.
  
  
  RESULTS
  Mean blood loss was 254.13 mL in the saline group and 235.6 mL in the tranexamic group (P=0.31). No statistically significant differences between the two groups were found in terms of other investigated variables, such as surgical field quality based on Boezzart's scale (P=0.30), surgeon satisfaction based on a Likert scale (P=0.54), or duration of surgery (P=0.22).
  
  
  CONCLUSIONS
  Use of tranexamic acid (2 g in 400 mL normal saline) through washing of the nasal mucosa during FESS did not significantly reduce blood loss or improve the surgical field of view. Further studies with larger sample sizes and higher drug concentrations, and using other methods of administration, such as spraying or applying pledgets soaked in tranexamic acid, are recommended.
authors.affiliation: Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Baradaranfar
authors.affiliation: Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Dadgarnia
authors.affiliation: Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Mahmoudi
authors.affiliation: Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Nasim
authors.initials: N
authors.lastname: Behniafard
authors.affiliation: Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Atighechi
authors.affiliation: Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Vahid
authors.initials: V
authors.lastname: Zand
authors.affiliation: Medical Student, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Amin
authors.initials: A
authors.lastname: Baradaranfar
authors.affiliation: Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Sedighe
authors.initials: S
authors.lastname: Vaziribozorg
keywords: Bleeding; Polyposis; Rhinosinusitis; Sinus; Surgery; Topical; Tranexamic acid