Prophylactic Effect of a Low Dose of Tranexamic Acid on Reducing Bleeding in Septorhinoplasty
Background: Intraoperative bleeding and postoperative periorbital edema and ecchymosis are the main concerns in septorhinoplasty surgery. Tranexamic acid, an antifibrinolytic agent, is used to reduce bleeding in nasal surgeries. The aim of this prospective double blind, randomized, controlled study was to assess the efficacy of a prophylactic low dose of tranexamic acid on bleeding and periorbital edema and ecchymosis in open septorhinoplasty. Methods: 52 American Society of Anesthesiologists class I adult patients scheduled for open septorhinoplasty under total intravenous anesthesia were randomized into 3 groups to receive either a bolus dose of 500 mg oral or intravenous tranexamic acid or placebo prior to the surgery. Results: There were no significant differences in the intraoperative bleeding between the groups. The grade of periorbital edema and ecchymosis on the first, third, and seventh days after surgery were similar in the three groups. Conclusions: The efficacy of a prophylactic single dose of 500 mg tranexamic acid on the intraoperative bleeding and postoperative edema and ecchymosis was similar to that of placebo in open septorhinoplasty.