Effects of Topical Antifibrinolytics in Endoscopic Sinus Surgery: A Pilot Randomized Controlled Trial

Athanasiadis, Theodore; Beule, Achim G.; Wormald, Peter John

doi:10.2500/ajr.2007.21.3097

Cited by 74 publications

(75 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The surgical field quality was reported on two different scoring system, the Boezaart system (37) by Alimian et al (32) , Athanasiadis et al (33) and Jabalameli et al (35) , and the Wormald system (33) by…”

Section: Surgical Field Qualitymentioning

confidence: 99%

Role of tranexamic acid in endoscopic sinus surgery - A systematic review and meta-analysis

Pundir¹,

Pundir²,

Georgalas

et al. 2013

Rhin

View full text Add to dashboard Cite

SummaryBackground: The role of tranexamic acid in patients undergoing endoscopic sinus surgery (ESS) is not clearly defined. The aim of our study is to systematically review the existing evidence on the role of tranexamic acid in patients undergoing ESS.Methodology: Systematic search of MEDLINE (1950MEDLINE ( -2013, EMBASE (1980EMBASE ( -2013, metaRegister, Cochrane Library and ISI conference proceedings was carried out. Results:Five randomised controlled trials with 192 patients receiving tranexamic acid and 196 controls were included. Metaanalysis demonstrated that mean estimated blood loss was significantly lower, and surgical field quality was significantly better in tranexamic acid group. There was no significant difference in mean operative time between the two groups. No significant adverse effects were noted in either of the groups. Conclusion:Intra-operative use of local and systemic tranexamic acid in ESS, results in significantly reduced estimated blood loss and improved surgical field quality. There is no statistically significant difference seen in operative time and incidence of side effects. Well-conducted larger RCTs using validated objective outcome measures and reporting on minor and major complications are required.

show abstract

Section: Surgical Field Qualitymentioning

confidence: 99%

Role of tranexamic acid in endoscopic sinus surgery - A systematic review and meta-analysis

Pundir¹,

Pundir²,

Georgalas

et al. 2013

Rhin

View full text Add to dashboard Cite

show abstract

“…They include porcine gelatin (Surgiflo Ò ; Johnson & Johnson, Somerville, NJ) [6], topical antifibrinolytics (Amicar Ò ; Xanodyne Pharmacal, Inc., Florence, KY) [7], hyaluronic acid [3,8], oxidized regenerated cellulose (Surgicel Ò ; Xanodyne Pharmacal, Inc., Florence, KY) [9], and polyethylene glycol (Nasopore Ò ; Stryker Canada, Hamilton, Ontario, Canada) [10]. Several studies showed effectiveness of these materials in eliminating a painful removal procedure and preventing postoperative bleeding and adhesion [3,5,8].…”

Section: Introductionmentioning

confidence: 99%

Comparison between Gelfoam packing and no packing after endoscopic sinus surgery in the same patients

Wee

Lee

Rhee

et al. 2011

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

After functional endoscopic sinus surgery (FESS), nasal packing may be necessary and a packing material which has benefits in both cost and efficacy would be required. This study aimed to determine the efficacy of Gelfoam packing on hemostasis and wound healing after FESS. Patients who underwent bilateral FESS due to chronic bilateral rhinosinusitis were enrolled. Randomly, one side was selected for Gelfoam packing and the other side for no packing. Subjective symptoms and objective findings such as synechia, granulation, pus discharge, edema, stenosis, and crust were evaluated. A total of 21 patients (17 men and 4 women; mean age 39.7 years ranging from 12 to 75 years) were included. There were no statistical significant differences between two groups regarding both subjective symptoms and objective findings during 4 months after surgery. Three patients had postoperative bleeding in the no packing side. Gelfoam packing may be recommendable in terms of efficacy and cost-benefit after FESS.

show abstract

“…Topical administration results in a ten-fold less plasma concentration of TXA when compared to intravenous administration [8,64], with a potential reduction in adverse effects. Although topical TXA has been studied in cardiothoracic [65−68], orthopedic [64, 69−72], otorhinolaryngologic [73,74] and orthognathic [75−77] surgeries, high-quality trials are lacking.…”

Section: Topical Usementioning

confidence: 99%

Tranexamic acid: a clinical review

Jerath

Wąsowicz

2015

Anaesthesiol Intensive Ther

253

151

View full text Add to dashboard Cite

Blood loss and subsequent transfusions are associated with major morbidity and mortality. The use of antifibrinolytics can reduce blood loss in cardiac surgery, trauma, orthopedic surgery, liver surgery and solid organ transplantation, obstetrics and gynecology, neurosurgery and non-surgical diseases. The evidence of their efficacy has been mounting for years. Tranexamic acid (TXA), a synthetic lysine-analogue antifibrinolytic, was first patented in 1957 and its use has been increasing in contrast to aprotinin, a serine protease inhibitor antifibrinolytic. This review aims to help acute care physicians navigate through the clinical evidence available for TXA therapy, develop appropriate dose regimens whilst minimizing harm, as well as understand its broadening scope of applications. Many questions remain unanswered regarding other clinical effects of TXA such as anti-inflammatory response to cardiopulmonary bypass, the risk of thromboembolic events, adverse neurological effects such as seizures, and its morbidity and mortality, all of which necessitate further clinical trials on its usage and safety in various clinical settings.

show abstract

Effects of Topical Antifibrinolytics in Endoscopic Sinus Surgery: A Pilot Randomized Controlled Trial

Abstract: Topical application of TA is effective in achieving hemostasis and improving the surgical field. In contrast to EACA, TA is a valuable tool in ESS that merits additional evaluation.

Cited by 74 publications

References 38 publications

Role of tranexamic acid in endoscopic sinus surgery - A systematic review and meta-analysis

Role of tranexamic acid in endoscopic sinus surgery - A systematic review and meta-analysis

Comparison between Gelfoam packing and no packing after endoscopic sinus surgery in the same patients

Tranexamic acid: a clinical review

Contact Info

Product

Resources

About