Short-term Use of Tranexamic Acid to Reduce Blood Loss in Endoscopic Nasal Surgeries

Objective To evaluate the effect of tranexamic acid, an antifibrinolytic agent, in reduction of surgical hemorrhage during endoscopic nasal surgery. Design Comparative analysis of the use of tranexamic acid in 200 patients undergoing endoscopic nasal surgery and its demonstrable reduction of hemorrhage and improvement of visibility of operative field. Subjects Around 200 patients with varied indications underwent endoscopic nasal surgery; 100 were given tranexamic acid perioperatively and 100 did not receive tranexamic acid and were used as a control. Selection of patients was done on random basis. We used the following parameters to measure intraoperative blood loss: Visibility of field of surgery, weight of blood swabs postoperatively and amount of blood from suction machine. Result Patient who received tranexamic acid showed reduction of blood loss amounting to 72.48% (p < 0.05). This reduction was compared with results published by other authors using various kinds of anesthesia. Conclusions Tranexamic acid is an antifibrinolytic agent which inhibits the action of plasmin. There is also reduction in blood level of D-dimer. It is seen to significantly reduce intraoperative blood loss during endoscopic nasal surgery. Additionally, there seems to be no alteration of coagulation parameters or untoward systemic effects. The consequent improvement in surgical field visibility is of great benefit which is encouraging and should prompt further trials.