Effectiveness of tranexamic acid on intra- and postoperative bleeding in Bimaxillary osteotomies: a retrospective study.

IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Oral and Maxillofacial Surgery-Heidelberg Pub Date : 2024-12-01 Epub Date: 2024-09-03 DOI:10.1007/s10006-024-01288-1

Ayako Mizutani, Takuro Sanuki, Kanta Kido

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Abstract

Purpose: Perioperative bleeding is a serious concern during orthognathic surgery. Tranexamic acid (TXA), a synthetic lysine analog with antifibrinolytic properties, reduces blood loss across various surgical fields. This study aimed to investigate the effectiveness of preoperative TXA administration in reducing intraoperative and postoperative blood loss following combined Le Fort I and sagittal split ramus osteotomies at our hospital.

Methods: This single-center, retrospective cohort study included patients who underwent combined Le Fort I and sagittal split ramus osteotomies between November 2017 and October 2022. The primary outcome was the volume of intraoperative blood loss.

Results: Among 1,329 eligible patients, 87 were included in the analysis (32 in the TXA group and 55 in the control group, where no TXA was administered). The median (interquartile range) intraoperative blood loss was 200.0 (157.5-237.5) mL in the TXA group and 260.0 (180.0-350.0) mL in the control group, showing a significant difference between the groups (p = 0.0365). However, postoperative blood drainage within 24 h and 24-48 h did not differ significantly between the two groups.

Conclusion: A single intravenous administration of TXA was associated with a decrease in intraoperative bleeding without severe adverse events during combined Le Fort I and sagittal split ramus osteotomies. However, postoperative blood loss, nausea, vomiting, and autologous blood transfusion were not significantly associated with this administration.

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氨甲环酸对双颌截骨术术中和术后出血的影响：一项回顾性研究。

目的：围手术期出血是正颌外科手术中的一个严重问题。氨甲环酸（TXA）是一种具有抗纤维蛋白溶解特性的合成赖氨酸类似物，可减少各种手术领域的失血量。本研究旨在探讨在我院进行的 Le Fort I 和矢状劈裂臼齿联合截骨术中，术前服用氨甲环酸对减少术中和术后失血量的有效性：这项单中心、回顾性队列研究纳入了2017年11月至2022年10月期间接受Le Fort I和矢状劈裂臼联合截骨术的患者。主要结果是术中失血量：在1329名符合条件的患者中，有87人被纳入分析（TXA组32人，对照组55人，未使用TXA）。TXA 组的术中失血量中位数（四分位数间距）为 200.0（157.5-237.5）毫升，对照组为 260.0（180.0-350.0）毫升，两组间差异显著（P = 0.0365）。然而，术后 24 小时内和 24-48 小时内的排血量在两组之间没有明显差异：结论：在 Le Fort I 型和矢状劈开斜骨联合截骨术中，单次静脉注射 TXA 可减少术中出血，且无严重不良反应。然而，术后失血、恶心、呕吐和自体输血与该用药并无明显关联。

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来源期刊

Oral and Maxillofacial Surgery-Heidelberg DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.20

自引率

5.60%

发文量

118

期刊介绍： Oral & Maxillofacial Surgery founded as Mund-, Kiefer- und Gesichtschirurgie is a peer-reviewed online journal. It is designed for clinicians as well as researchers.The quarterly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery and interdisciplinary aspects of cranial, facial and oral diseases and their management. The journal publishes papers of the highest scientific merit and widest possible scope on work in oral and maxillofacial surgery as well as supporting specialties. Practice-oriented articles help improve the methods used in oral and maxillofacial surgery.Every aspect of oral and maxillofacial surgery is fully covered through a range of invited review articles, clinical and research articles, technical notes, abstracts, and case reports. Specific topics are: aesthetic facial surgery, clinical pathology, computer-assisted surgery, congenital and craniofacial deformities, dentoalveolar surgery, head and neck oncology, implant dentistry, oral medicine, orthognathic surgery, reconstructive surgery, skull base surgery, TMJ and trauma.Time-limited reviewing and electronic processing allow to publish articles as fast as possible. Accepted articles are rapidly accessible online.Clinical studies submitted for publication have to include a declaration that they have been approved by an ethical committee according to the World Medical Association Declaration of Helsinki 1964 (last amendment during the 52nd World Medical Association General Assembly, Edinburgh, Scotland, October 2000). Experimental animal studies have to be carried out according to the principles of laboratory animal care (NIH publication No 86-23, revised 1985).