Efficacy of tranexamic acid (TXA) for post-tonsillectomy hemorrhage

Spencer, Raven; Newby, Maxwell; Hickman, William P.; Williams, Nathan; Kellermeyer, Brian

doi:10.1016/j.amjoto.2022.103582

Cited by 6 publications

(2 citation statements)

References 15 publications

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“…Spencer demonstrated that the use of tranexamic acid in any method of application avoided the need of cauterization in an operating room in 77.8% of patients ; but when it is used in topic administration there is no evidence of the dose necessary to reduce bleeding [19]. Robb's review [6,10] shows that the use of tranexamic acid in oral rinses can be applied to control intraoperative bleeding, both in oral surgery and tonsillectomy, they do not decrease the frequency of post-surgical bleeding but reduce its quantity.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2024

OJOR

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Introduction: Tonsillectomy is the most widely performed procedure worldwide, with complications like bleeding which is divided into primary that occurs within 24 hours and secondary at any point more than 24 hours after surgery. Among the drugs used to reduce the risk of bleeding, we have tranexamic acid; its use topical has not been described for early or late tonsil bleeding. Materials and Methods:The medical records with diagnosis of post-tonsillectomy hemorrhage that have been treated with topical tranexamic acid at the Carlos Andrade Marin Specialties Hospital and the Private Hospital of the city of Quito in the period 2018-2022 were analyzed. The study population was six adult patients.Results: Topical tranexamic acid was administered; it was evident that with the first instillation the bleeding was controlled in the 83.3%, oral tolerance began from 12 hours after the scheme started; a patient failed and need emergency surgery. Conclusion:Administration of topical tranexamic acid was successful in controlling post-tonsillectomy hemorrhage.

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Section: Discussionmentioning

confidence: 99%

Untitled

2024

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“…Spencer et al retrospectively reviewed the charts of adult and pediatric patients who underwent tonsillectomy and reported that the requirement for surgical control of post-tonsillectomy hemorrhage reduced when it was treated with TXA 15 . By comparing 15 mg/kg intravenous TXA with controls.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Tranexamic Acid Local Injection on Bleeding during and after Tonsillectomy: A Double-Blind Randomized Placebo-Controlled Trial

Abtahi,

Kargoshai,

Shetabi

et al. 2023

WJPS

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Background: Tonsillectomy-related bleeding is one of the most prevalent and potentially fatal complications of this common surgical procedure. We aimed to assess the effect of tranexamic acid (TXA) local injection on bleeding during and after tonsillectomy. Methods: This double-blind, randomized placebo-controlled trial included 20 candidates for tonsillectomy referred to Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran, in 2022. The subjects were randomized into two groups. Ten patients received TXA on their left side and the other ten on their right side 10 min before surgery. Placebo was administered to the contralateral side. The primary outcome was the volume of blood loss during tonsillectomy and up to 24 hours post-tonsillectomy. The secondary outcomes were surgeon satisfaction (rated 0-10), hemodynamic complications (patients’ heart rate (HR) and mean arterial pressure (MAP) were recorded every 10 min), and rebleeding. The duration of surgery was also noted. Results: The mean age of the patients was 21.35 ± 3.16 years, of whom 8 (30%) were male and 12 (60%) were female. there was no significant difference between groups in terms of HR and MAP at any time point. The median of surgery duration did not differ significantly between the two groups; however, the surgeon satisfaction with the procedure was significantly higher with TXA compared to placebo. None of the patients developed hemodynamic complications, and rebleeding did not occur in any of the subjects. Conclusions: TXA local injection was not superior to placebo in terms of bleeding control during and after tonsillectomy, hemodynamic complications, rebleeding, and surgery duration.

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