Effect of intravenous tranexamic acid and epsilon aminocaproic acid on bleeding and surgical field quality during functional endoscopic sinus surgery (FESS)
Objective: Mucosal bleeding during FESS often interferes with optimal visualization of the nasal surgical field and can impair the safety and efficiency of the procedure. This study was conducted to evaluate the efficacy of tranexamic acid and Epsilon Aminocaproic Acid to decrease bleeding and impro...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2015-01-01
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| Series: | Egyptian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1110184914000695 |
| _version_ | 1819126155937054720 |
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| author | Sahar M. El Shal Riham Hasanein |
| author_facet | Sahar M. El Shal Riham Hasanein |
| author_sort | Sahar M. El Shal |
| collection | DOAJ |
| description | Objective: Mucosal bleeding during FESS often interferes with optimal visualization of the nasal surgical field and can impair the safety and efficiency of the procedure. This study was conducted to evaluate the efficacy of tranexamic acid and Epsilon Aminocaproic Acid to decrease bleeding and improve visualization of the surgical field during FESS.
Materials and methods: A total of 90 patients ASA I-II aged from 18 to 50 years and undergoing FESS for chronic sinusitis were enrolled in this study. Surgery was performed under general anesthesia patients were randomly assigned to three equal groups (30 patients each), patients in TXA group received intravenous tranexamic acid 10 mg/kg diluted in 100 ml saline. EACA group received intravenous Epsilon Aminocaproic Acid 100 mg/kg diluted in 100 ml saline and the control group received IV 100 ml normal saline (all infusions were through 10 min). The duration of surgery, volume of blood loss, pre and postoperative hemoglobin, MAP and HR, surgical field quality surgeon satisfaction and side effects were recorded.
Results: The duration of surgery was significantly less in TXA and EACA groups than the control group (121.1 ± 7.1 min), (120.8 ± 6.0 min), versus (146.1 ± 7.3 min) volume of blood loss in TXA group and EACA group was comparable (195.3 ± 32.2 ml) and (201.5 ± 30.6 ml) but each of them has significant less blood loss than the control group (365.1 ± 48.8 ml). The postoperative hemoglobin was significantly lower in the control group (11.9 ± 0.4 gm/dl) compared to TXA group (12.6 ± 0.2 gm/dl) and EACA group (12.4 ± 0.2 gm/dl). Both TXA and EACA groups had comparable improved quality of the surgical field with most of patients classified as grade 1 and 2 according to Boezaart scale while the control group had most of patients in grade 3, accordingly the surgeon satisfaction is significantly higher in TXA and EACA groups compared to the control group. No significant difference in side effects between all groups.
Conclusion: Intravenous tranexamic acid and Epsilon Aminocaproic Acid (EACA) effectively reduce bleeding during FESS and improve visualization of the surgical field and so increase the surgeon satisfaction with no significant difference between both drugs. |
| first_indexed | 2024-12-22T07:51:33Z |
| format | Article |
| id | doaj.art-cd3ffc00f3254424be4e4c46eec8da93 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-12-22T07:51:33Z |
| publishDate | 2015-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-cd3ffc00f3254424be4e4c46eec8da932022-12-21T18:33:28ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492015-01-013111710.1016/j.egja.2014.08.002Effect of intravenous tranexamic acid and epsilon aminocaproic acid on bleeding and surgical field quality during functional endoscopic sinus surgery (FESS)Sahar M. El ShalRiham HasaneinObjective: Mucosal bleeding during FESS often interferes with optimal visualization of the nasal surgical field and can impair the safety and efficiency of the procedure. This study was conducted to evaluate the efficacy of tranexamic acid and Epsilon Aminocaproic Acid to decrease bleeding and improve visualization of the surgical field during FESS. Materials and methods: A total of 90 patients ASA I-II aged from 18 to 50 years and undergoing FESS for chronic sinusitis were enrolled in this study. Surgery was performed under general anesthesia patients were randomly assigned to three equal groups (30 patients each), patients in TXA group received intravenous tranexamic acid 10 mg/kg diluted in 100 ml saline. EACA group received intravenous Epsilon Aminocaproic Acid 100 mg/kg diluted in 100 ml saline and the control group received IV 100 ml normal saline (all infusions were through 10 min). The duration of surgery, volume of blood loss, pre and postoperative hemoglobin, MAP and HR, surgical field quality surgeon satisfaction and side effects were recorded. Results: The duration of surgery was significantly less in TXA and EACA groups than the control group (121.1 ± 7.1 min), (120.8 ± 6.0 min), versus (146.1 ± 7.3 min) volume of blood loss in TXA group and EACA group was comparable (195.3 ± 32.2 ml) and (201.5 ± 30.6 ml) but each of them has significant less blood loss than the control group (365.1 ± 48.8 ml). The postoperative hemoglobin was significantly lower in the control group (11.9 ± 0.4 gm/dl) compared to TXA group (12.6 ± 0.2 gm/dl) and EACA group (12.4 ± 0.2 gm/dl). Both TXA and EACA groups had comparable improved quality of the surgical field with most of patients classified as grade 1 and 2 according to Boezaart scale while the control group had most of patients in grade 3, accordingly the surgeon satisfaction is significantly higher in TXA and EACA groups compared to the control group. No significant difference in side effects between all groups. Conclusion: Intravenous tranexamic acid and Epsilon Aminocaproic Acid (EACA) effectively reduce bleeding during FESS and improve visualization of the surgical field and so increase the surgeon satisfaction with no significant difference between both drugs.http://www.sciencedirect.com/science/article/pii/S1110184914000695Functional endoscopic sinus surgeryBleedingTranexamic acidAminocaproic acidSurgical field quality |
| spellingShingle | Sahar M. El Shal Riham Hasanein Effect of intravenous tranexamic acid and epsilon aminocaproic acid on bleeding and surgical field quality during functional endoscopic sinus surgery (FESS) Egyptian Journal of Anaesthesia Functional endoscopic sinus surgery Bleeding Tranexamic acid Aminocaproic acid Surgical field quality |
| title | Effect of intravenous tranexamic acid and epsilon aminocaproic acid on bleeding and surgical field quality during functional endoscopic sinus surgery (FESS) |
| title_full | Effect of intravenous tranexamic acid and epsilon aminocaproic acid on bleeding and surgical field quality during functional endoscopic sinus surgery (FESS) |
| title_fullStr | Effect of intravenous tranexamic acid and epsilon aminocaproic acid on bleeding and surgical field quality during functional endoscopic sinus surgery (FESS) |
| title_full_unstemmed | Effect of intravenous tranexamic acid and epsilon aminocaproic acid on bleeding and surgical field quality during functional endoscopic sinus surgery (FESS) |
| title_short | Effect of intravenous tranexamic acid and epsilon aminocaproic acid on bleeding and surgical field quality during functional endoscopic sinus surgery (FESS) |
| title_sort | effect of intravenous tranexamic acid and epsilon aminocaproic acid on bleeding and surgical field quality during functional endoscopic sinus surgery fess |
| topic | Functional endoscopic sinus surgery Bleeding Tranexamic acid Aminocaproic acid Surgical field quality |
| url | http://www.sciencedirect.com/science/article/pii/S1110184914000695 |
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