The Effect of Tranexamic Acid Local Injection on Bleeding during and after Tonsillectomy: A Double-Blind Randomized Placebo-Controlled Trial.

IF 0.9 Q3 SURGERY World Journal of Plastic Surgery Pub Date : 2023-01-01 DOI:10.61186/wjps.12.3.31
Mojtaba Abtahi, Amir-Abbas Kargoshai, Hamidreza Shetabi, Amir Manafi, Navid Manafi, Ali Badrouj
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Abstract

Background: Tonsillectomy-related bleeding is one of the most prevalent and potentially fatal complications of this common surgical procedure. We aimed to assess the effect of tranexamic acid (TXA) local injection on bleeding during and after tonsillectomy.

Methods: This double-blind, randomized placebo-controlled trial included 20 candidates for tonsillectomy referred to Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran, in 2022. The subjects were randomized into two groups. Ten patients received TXA on their left side and the other ten on their right side 10 min before surgery. Placebo was administered to the contralateral side. The primary outcome was the volume of blood loss during tonsillectomy and up to 24 hours post-tonsillectomy. The secondary outcomes were surgeon satisfaction (rated 0-10), hemodynamic complications (patients' heart rate (HR) and mean arterial pressure (MAP) were recorded every 10 min), and rebleeding. The duration of surgery was also noted.

Results: The mean age of the patients was 21.35 ± 3.16 years, of whom 8 (30%) were male and 12 (60%) were female. there was no significant difference between groups in terms of HR and MAP at any time point. The median of surgery duration did not differ significantly between the two groups; however, the surgeon satisfaction with the procedure was significantly higher with TXA compared to placebo. None of the patients developed hemodynamic complications, and rebleeding did not occur in any of the subjects.

Conclusions: TXA local injection was not superior to placebo in terms of bleeding control during and after tonsillectomy, hemodynamic complications, rebleeding, and surgery duration.

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氨甲环酸局部注射对扁桃体切除术中和术后出血的影响:双盲随机安慰剂对照试验
背景:扁桃体切除术相关出血是这种常见外科手术中最常见且可能致命的并发症之一。我们旨在评估氨甲环酸(TXA)局部注射对扁桃体切除术中和术后出血的影响:这项双盲、随机安慰剂对照试验纳入了 20 名 2022 年转诊至伊朗伊斯法罕市伊斯法罕医科大学扎赫拉医院接受扁桃体切除术的患者。受试者被随机分为两组。10 名患者在手术前 10 分钟在左侧接受 TXA 治疗,另 10 名患者在右侧接受 TXA 治疗。对侧注射安慰剂。主要结果是扁桃体切除术中和扁桃体切除术后 24 小时内的失血量。次要结果是外科医生满意度(评分 0-10)、血液动力学并发症(每 10 分钟记录一次患者的心率(HR)和平均动脉压(MAP))和再出血。同时还记录了手术持续时间:患者的平均年龄为 21.35 ± 3.16 岁,其中男性 8 人(30%),女性 12 人(60%)。两组手术持续时间的中位数无明显差异;但外科医生对 TXA 手术的满意度明显高于安慰剂。没有一名患者出现血流动力学并发症,也没有任何受试者再出血:结论:就扁桃体切除术中和术后的出血控制、血液动力学并发症、再出血和手术持续时间而言,TXA局部注射剂并不优于安慰剂。
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