Efficacy of Tranexamic Acid in reducing intra-operative bleeding during tonsillectomy

Tranexamic Acid during Tonsillectomy

Abstract

Background: Our study aims to determine the effectiveness of tranexamic acid in decreasing the intraoperative blood loss during tonsillectomy.

Materials and Methods: Study design was randomized double-blind control trial.  This study was conducted from 1 November 2017 till 30 June 2019 in the department of ENT unit-II, the civil sandeman provincial teaching hospital Quetta. Ethical approval was taken from Ethical Review Board of the civil Sandeman provincial teaching hospital Quetta. A sample of 100 patients were surveyed, 55 men and 45 woman, 10-30 year age range, 1.2:1 men to female with a mean 20 year age. Patients who met the criteria for inclusion experiencing an elective tonsillectomy were randomly assigned to two groups. Every community has equivalent patients. An injection of 10 mg/kg body weight was given intravenously into group-A 5-10 minutes prior to surgery, and normal saline of the same amount was administered intravenously into group-B. Intraoperative bleeding was measured at Operation Theatre in both groups during surgery. In intraoperative blood loss, the effectiveness of tranexamic acid / placebo was determined by measuring loss of blood computed by Gravimetric method and blood obtained in suction jar by measuring.

Results: In Group-A and Group-B patients, there was a significant difference in intra-operative loss of blood during tonsillectomy. In group A, intra-operatively, there was overall blood loss of 1404 ml and the average blood loss was 33ml. During surgery in group-B the blood loss was 3132 ml, and the average loss of blood was 62-64ml.  As a result, group B was more intraoperative bleeding and consumed more time compared to group A.

Conclusion: Study group patients receiving preoperative intravenous tranexamic acid have less intraoperative loss of blood and less time consuming than placebo patients who have not obtained tranexamic acid intravenous.