Effect of Tranexamic Acid and H2O2 on Blood Loss during Functional Endoscopic Sinus Surgery

Background : It might be dangerous and further obstruct the surgical fi eld to have intraoperative bleeding during endoscopic sinus surgery (ESS). Tranexamic acid may be able to reduce bleeding during surgery. Aim : Assess the effect of topical TXA and hydrogen peroxide (H 2 O 2 ) solution on bleeding and improvement of surgical fi eld during functional endoscopic sinus surgeries (FESS) in patients with chronic sinusitis with or without sino nasal polyposis. Patients and methods : 30 patients were included, for all the 30 patients, Pads soaked with TXA 5% was introduced in one side of the nasal cavity for 10 min then irrigation by 3% H 2 O 2 solution which was freshly prepared by a 50% dilution with a physiological saline solution. The other side of the nasal cavity was not receive pads of TXA nor H 2 O 2 and was only on controlled blood pressure during the operation. Result : There was statistically signi fi cant difference between both sides with time reduced in applied side after the application of tranexamic acid and H 2 O 2 wash regarding surgical fi eld by Boezaart grading,but it is non-signi fi cant in control side. There were statistically signi fi cant differences according to blood loss between both sides of the nose after application of tranexamic acid and H 2 O 2 wash either after 15, 30, and 45 min. Conclusion : The application of topical TXA with the irrigation with 3% H 2 O 2 may be a useful method for providing a suitable surgical fi eld.