The effect of intravenous tranexamic acid on blood loss and surgical field quality during endoscopic sinus surgery: a placebo-controlled clinical trial.

STUDY OBJECTIVES To evaluate the effects of intravenous (IV) tranexamic acid on blood loss and surgical field quality during functional endoscopic sinus surgery (FESS). DESIGN Randomized, double-blinded, controlled trial. SETTING Operating room and postoperative recovery area of a university-affiliated hospital. PATIENTS 84 consecutive, adult, ASA physical status 1 and 2 patients undergoing FESS. INTERVENTIONS Patients were randomized to receive either IV tranexamic acid 10 mg/kg (TA group) or sterile water 0.1 mL/kg (placebo group) as a bolus dose immediately after induction of anesthesia. MEASUREMENTS Amount of blood loss and bleeding and satisfaction scores were obtained from the surgeon. MAIN RESULTS Blood loss in the TA group was 184 ± 64 mL and in the placebo group, 312 ± 75 mL on average (P < 0.01). The median (range) bleeding score in the TA group was significantly lower than the placebo group [2 (1-3) vs 2.5 (2-4); P < 0.0001]. The surgeon was more satisfied with the surgical field in the TA group than the placebo group [median score: 4 (3-5) vs 3 (1-5), P < 0.001]. CONCLUSION Intravenous tranexamic acid effectively reduces bleeding and improves the surgical field during FESS.