Investigation of the effectiveness of tranexamic acid solution to optimize the control of perioperative bleeding during tonsillectomy

Pukhlik, Sergey M.; KOLESNICHENKO, Volodymyr; Gushcha, Sergеy

doi:10.12680/balneo.2020.332

Cited by 2 publications

(10 citation statements)

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“…Based on the NOS, all non-randomized studies 17,18,20,22,23,26 received a score between 6 and 8, indicating that they had fair methodological quality (Table 4). Most of the RCTs 19,21,24,25 had a low risk of bias (Figure 2), except for the study conducted by Castelli and Vogt 25 due to poor blinding of participants and personnel.…”

Section: General Characteristics and Methodological Quality Of Studiesmentioning

confidence: 99%

The efficacy of Tranexamic Acid Administration in Patients Undergoing Tonsillectomy: An Updated Meta-Analysis

Kuo

DeGiovanni

Carr

2021

Ann Otol Rhinol Laryngol

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Objective: There is controversy regarding the efficacy and safety of tranexamic acid (TXA) in reducing tonsillectomy-related hemorrhage. We conducted a systematic review and meta-analysis to evaluate the prophylactic role of TXA in tonsillectomy. Methods: We searched 6 databases to identify studies that directly compare the effect of TXA versus controls in tonsillectomy patients. Standardized mean difference was applied to summate the findings across the studies. Dichotomous data were expressed as relative risk. Results: Ten studies representing a total of 111 898 patients were included. The pooled results showed a significant reduction of intraoperative blood loss by 39.02 ml (SMD = −1.05, 95% CI: −1.91 to −0.20, P = .016) and the rate of post-tonsillectomy hemorrhage (RR = 0.42, 95% CI: 0.28 to 0.65, P < .0001), with no significant difference in reduction of further intervention risk (RR = 0.78, 95% CI: 0.45 to 1.35, P = .373). Conclusions: Overall, this study indicates that TXA may reduce blood loss and frequency of post-operative hemorrhage associated with tonsillectomy. Further large, high-quality clinical trials are still needed to explore TXA’s effect on post-tonsillectomy hemorrhage and the safety of its use.

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Section: General Characteristics and Methodological Quality Of Studiesmentioning

confidence: 99%

The efficacy of Tranexamic Acid Administration in Patients Undergoing Tonsillectomy: An Updated Meta-Analysis

Kuo

DeGiovanni

Carr

2021

Ann Otol Rhinol Laryngol

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“…[23][24][25]29,30 Four out of these five studies reported significant reduction in the volume of intraoperative blood loss. [23][24][25]30 Santosh et al 23 reported a mean reduction of 40.72 mL in their study group while George et al 24 reported a reduction of 29.68 mL. Achakzai et al 30 similarly reported a reduction of 29.59 mL in their study group.…”

Section: Intraoperative Bleedingmentioning

confidence: 99%

“…into two main categories-8 out of the 16 studies were identified to be major H&N surgical studies [6][7][8][18][19][20][21][22] while the other 8 were tonsillectomy studies. [23][24][25][26][27][28][29][30] The characteristics of the studies for the tonsillectomy studies are defined in Table 4 and for the H&N studies in Table 5, including a breakdown of the type of H&N operations undertaken. There were 941 patients in the H&N studies and there 113 466 patients in the tonsillectomy studies.…”

Section: The Rates Of Secondary Posttonsillectomy Haemorrhagementioning

confidence: 99%

“…Ten studies reported on the requirement of blood transfusions or the number of re-interventions or the incidences of postoperative haemorrhages. 7,8,18,20,21,[25][26][27][28][29] Heterogeneity amongst outcome assessment precluded meta-analysis. 31 Three out of these nine studies reported a clinically significant impact of TXA.…”

Section: The Clinical Impact Of Txamentioning

confidence: 99%

“…Significant reductions in intraoperative blood loss were found with the use of TXA in tonsillectomy patients. [23][24][25]29,30 Since the overall intraoperative blood loss is minimal during tonsillectomy, 37 the therapeutic importance of these reductions is debatable. Moreover, two of the tonsillectomy studies 24,25 investigated the impact on the duration of the surgery and both reported clinically significant reductions.…”

Section: The Clinical Impact Of Txamentioning

confidence: 99%

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A systematic review on the efficacy of tranexamic acid in head and neck surgery

Jamshaid

Coulson

et al. 2023

Clinical Otolaryngology

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Background Intraoperative and postoperative blood loss is a major risk in head and neck (H&N) surgery. Recently the use of tranexamic acid (TXA) has been investigated by multiple studies for reducing intraoperative and postoperative bleeding, however reported results are variable. Objectives To determine the safety and efficacy of TXA use in H&N surgery. Methods Systematic review of MEDLINE, EMBASE, CINAHL, Cochrane Library, PubMed, ClinicalKey, and Clinicaltrials.gov according to the PRISMA guidelines. Studies were included if they reported on intraoperative bleeding, volume or duration of postoperative drain or return to theatre rate for postoperative haemorrhage in adult populations following use of TXA. Risk of bias assessment with Cochrane Risk of Bias (RoB2) tool for randomised controlled trials and Newcastle–Ottawa Scale tool for non‐randomised studies. Results Sixteen studies were identified (114 407 patients). Eight studies evaluated TXA in major H&N surgery and eight studies in tonsillectomy. Primary outcomes were reduction in intraoperative or postoperative bleeding. Secondary outcomes included the duration of postoperative drain placement and return to theatre rate. No adverse events were reported in any patients. TXA is effective in reducing intraoperative blood loss in tonsillectomy. However, the effect on posttonsillectomy haemorrhage was unclear. Insufficient evidence exists of benefit of TXA on intraoperative bleeding in major H&N procedures. Postoperative drainage volumes were significantly reduced in most major H&N studies. The duration of drain placement and risk of blood transfusion was unchanged in most cases. Conclusion TXA use is safe in H&N patients. Whilst sufficient evidence exists to support the use of TXA in tonsillectomy, insufficient evidence exists to recommend use in major H&N surgery.

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Investigation of the effectiveness of tranexamic acid solution to optimize the control of perioperative bleeding during tonsillectomy

Cited by 2 publications

References 0 publications

The efficacy of Tranexamic Acid Administration in Patients Undergoing Tonsillectomy: An Updated Meta-Analysis

The efficacy of Tranexamic Acid Administration in Patients Undergoing Tonsillectomy: An Updated Meta-Analysis

A systematic review on the efficacy of tranexamic acid in head and neck surgery

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