Efficacy of dexmedetomidine on perioperative morbidity during nasal surgery: A meta‐analysis

Abstract

NA. Laryngoscope, 128:573-580, 2018.

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

“…Tranexamic acid is a synthetic derivative of the amino acid lysine that blocks the lysine‐binding sites of plasminogen, inhibiting plasminogen activation and fibrin binding to plasminogen and therefore impairing fibrinolysis . Several investigations have been conducted to establish the efficacy of tranexamic acid in endoscopic sinus surgery . A previous systematic review that pooled data from those studies documented that tranexamic acid decreased intraoperative blood loss and improved the quality of the operative field for endoscopic sinus surgery …”

“…The previous meta‐analysis evaluated only the incidence of emesis and thromboembolic events. Also, since publication of the previous meta‐analysis, additional studies have been published . Therefore, our current meta‐analysis is needed.…”

“…20,21 This method was chosen to calculate effect sizes due to the absence of a standardized scale for use across all studies to assess surgical time, intraoperative blood loss, surgical field score, surgeon's satisfaction, intraoperative blood pressure, and postoperative coagulation profiles. 12 In all other cases, the outcomes of the incidence analysis were performed using the odds ratio (OR). 14 A funnel plot and Egger test were used simultaneously to detect publication bias.…”

“…An electronic database search (PubMed, SCOPUS, Google scholar, Embase, and the Cochrane Register of Controlled Trials) using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines was conducted with the goal of identifying all available studies related to an preoperative tranexamic acid from inception of application of tranexamic acid and written in English up to July of 2018 . Two authors independently conducted the literature search using the search terms “endoscopic sinus surgery,” “tranexamic acid,” “general anesthesia,” “operative bleeding,” “surgical field,” “operative time,” “satisfaction,” “nausea and vomiting,” “thromboembolism,” and “hypotension.” We complemented the keyword‐based searches by the combinations of all possible keywords with hand‐screening of references listed in the retrieved articles …”

“…Regarding common cutoff values for SMD, the tranexamic acid effect was considered small when the SMD was smaller than 0.4, moderate mean that effect size is between 0.4 and 0.7., and large when it was larger than 0.7 . This method was chosen to calculate effect sizes due to the absence of a standardized scale for use across all studies to assess surgical time, intraoperative blood loss, surgical field score, surgeon's satisfaction, intraoperative blood pressure, and postoperative coagulation profiles . In all other cases, the outcomes of the incidence analysis were performed using the odds ratio (OR) .…”