Impact of Intravenous Tranexamic Acid on Intraoperative Bleeding during Endoscopic Sinus Surgery

Abstract

Introduction
 Bleeding during surgery is one of the most important concerns in endoscopic sinus surgery (ESS). The study conducted was aimed at assessing the efficacy of tranexamic acid on bleeding during endoscopic sinus surgeries. 
 Materials and Methods
 A total of 30 patients were enrolled for the study. Lund and Mackay symptom score and radiological staging was used to compare clinical profile. The surgical field was assessed by the surgeon who was blinded, i.e., was not aware of which set of patients were receiving the drug. Boezaart and van de Merwe grading scale was used to assess the intraoperative surgical field. Both groups were selected so as to comprise of patients having similar clinical profile in terms of symptom score and radiological staging. 
 Results
 In the arm receiving tranexamic acid, blood loss was found to be less and statistically significant (p=0.0157). The surgical field in endoscopic sinus surgery is more important factor in determining the completion and satisfactory outcomes of the surgery. Significantly high percentage (80%) of patients who were given the drug had a grade 2 scale when compared to (26.7%) in patients not receiving the drug. The difference in score in surgical field grading scale was also statistically significant (p=0.0034). The reported side effects of tranexamic acid mainly include nausea, vomiting, and possibly arterial or venous thrombosis, however none of the patients in our study had any side effects of the drug. Post-operative stay in the hospital was uneventful. 
 Conclusion
 Intravenous Tranexamic acid reduced the intraoperative bleeding significantly and was useful in providing a better operative field.

Effect Of Intravenous Vs Topical Tranexamic Acid On Bleeding During Endoscopic Sinus Surgery

“…Conclusion, intravenous tranexamic acid significantly reduced intraoperative bleeding and improved the operative field. [27] Khanwalkar 2023 examined the clinical efficacy of Tranexamic acid (TXA) to reduce postoperative bleeding after endoscopic sinus or nasal surgery. April to November 2021 saw the randomised, double-blind placebo-controlled trial.…”