Tranexamic acid – a useful drug in ENT surgery?

Robb, Peter

doi:10.1017/s0022215114001285

Cited by 28 publications

(22 citation statements)

References 46 publications

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“…The most common adverse effects of tranexamic acid are gastrointestinal, including postoperative nausea and vomiting, but the incidence of those effects was low. With intravenous administration, a rapid bolus injection can cause significant hypotension . In this study, intraoperative blood pressure and the incidence of postoperative emesis showed no significant difference between the treatment group and the control group.…”

Section: Discussionmentioning

confidence: 48%

“…With intravenous administration, a rapid bolus injection can cause significant hypotension. 30 In this study, intraoperative blood pressure and the incidence of postoperative emesis showed no significant difference between the treatment group and the control group. Many studies have suggested that up to 15 mg/kg by intravenous infusion can be recommended in surgical procedures, 9 and the adverse effects of tranexamic acid are dose-dependent and uncommon at that recommended dose.…”

Section: Discussionmentioning

confidence: 50%

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Efficacy of tranexamic acid on operative bleeding in endoscopic sinus surgery: A meta‐analysis and systematic review

Kim

Kang

et al. 2018

The Laryngoscope

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Objectives Tranexamic acid might help control bleeding during surgery because of antifibrinolytic characteristics. We aimed to evaluate the effectiveness of systemic tranexamic acid compared to control in blood loss, operative time, and surgical field and incidence of postoperative emesis and thromboembolism in endoscopic sinus surgery. Methods Two authors independently searched six databases (PubMed, SCOPUS, Embase, the Web of Science, Google Scholar, and the Cochrane database) from their inception to July 2018. The included studies compared perioperative tranexamic acid administration (treatment group) with a placebo, and the outcomes of interest were intraoperative morbidities, including surgical time, operative bleeding, and hypotension; postoperative morbidities such as nausea and vomiting; and coagulation profiles. Results Seven studies comprising 562 participants were reviewed in this study. Operative time (standardized mean difference (SMD) = −0.60; 95% confidence interval (CI)[−0.93, −0.29]) and intraoperative blood loss (SMD = −0.66; 95% CI [−0.86, −0.46]) were statistically lower in the treatment group than placebo group; and the quality of the surgical field (SMD = −0.80; 95% CI [−1.12; −0.48]) and surgeon satisfaction (SMD = 1.74; 95% CI [1.36; 2.13]) were statistically higher in the treatment group than the placebo group. By contrast, there were no significant differences in the hemodynamic (SMD = 0.08; 95% CI [−0.20; 0.37]) and coagulation profiles (SMD = −0.18; 95% CI [−0.42, 0.07]) of the two groups. Additionally, tranexamic acid had no significant effect on emetic or thrombotic events compared to placebo. Conclusion This meta‐analysis showed that the systemic administration of tranexamic acid could decrease operative time and blood loss intraoperatively, increasing the satisfaction of surgeons. It did not provoke intraoperative hemodynamic instability, postoperative emetic events, or coagulation profile abnormality. Only a small number of studies were enrolled, so further trials are needed to confirm the results of this study. Laryngoscope, 129:800–807, 2019

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 50%

Efficacy of tranexamic acid on operative bleeding in endoscopic sinus surgery: A meta‐analysis and systematic review

Kim

Kang

et al. 2018

The Laryngoscope

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“…Sie ist deshalb im Routinefall verzichtbar. ▶ Die Gabe von Tranexamsäure, systemisch und topisch, bewirkt eine Blutungsreduktion um 30-40 % [149][150][151][152][153]. Die Qualität des Operationsgebietes verbessert sich [153].…”

Section: Vorbereitung Des Operationsgebietesunclassified

Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie

Weber

2015

Laryngo-Rhino-Otol

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Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases.Appropriate frame conditions provided, the respective procedures are safe and successful.These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery.The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinusoperation with extended surgery of the frontal (Draf type III), maxillary (grade 3-4, medial maxillectomy, prelacrimal approach) and sphenoid sinus.In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving.This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment.

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“…Hence it can be omitted in routine cases. The application of tranexamic acid, systemic or topical, leads to reduced bleeding by 30–40% [ 150 ], [ 151 ], [ 152 ], [ 153 ], [ 154 ]. The quality of the surgery site improves [ 154 ].…”

Section: Principles and Basics Of Endonasal Sinus Surgerymentioning

confidence: 99%