The effect of intravenous tranexamic acid on blood loss and surgical field quality during endoscopic sinus surgery: a placebo-controlled clinical trial

Alimian, Mahzad; Mohseni, Masood

doi:10.1016/j.jclinane.2011.03.004

Cited by 64 publications

(67 citation statements)

References 17 publications

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“…Pooled data for postoperative bleeding showed no bleeding out of 66 cases, and one case of bleeding out of 66 controls (32,33,36) .…”

Section: Adverse Effectsmentioning

confidence: 97%

“…Pooled data for post operative nausea or vomiting showed 6 patients out of 56 suffered with nausea and vomiting in tranexamic acid group compared to 4 out of 56 patients in the control group (32,36) . None of the studies reported serious thromboembolic event in any patients both in tranexamic acid and controls.…”

Section: Adverse Effectsmentioning

confidence: 97%

“…Five studies satisfied the selection criteria and were included in this review (32)(33)(34)(35)(36) , comprising of 192 patients receiving tranexamic acid and 196 controls (Figure 1). Sample size per study varied across the trials and ranged from 10 to 100 participants.…”

Section: Study Selectionmentioning

confidence: 99%

“…Intra-operative tranexamic acid was either used intravenously (32,34,36) or topically (33,35) . In our attempt to get more information about studies with unpublished data, we received response from Chhapola et.al (34) .…”

Section: Study Selectionmentioning

confidence: 99%

“…I2 was 99%, suggesting significant heterogeneity. Operating time Data addressing this comparison were available from two studies (32,36) . Pooling the results showed that mean operative time was not significantly different in the tranexamic acid group compared to the no tranexamic acid group (WMD -7.59 minutes; 95% CI -16.44, 1.26; p = 0.09; Figure 6).…”

Section: Estimated Blood Loss (Ebl)mentioning

confidence: 99%

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Role of tranexamic acid in endoscopic sinus surgery - A systematic review and meta-analysis

Pundir¹,

Pundir²,

Georgalas

et al. 2013

Rhin

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SummaryBackground: The role of tranexamic acid in patients undergoing endoscopic sinus surgery (ESS) is not clearly defined. The aim of our study is to systematically review the existing evidence on the role of tranexamic acid in patients undergoing ESS.Methodology: Systematic search of MEDLINE (1950MEDLINE ( -2013, EMBASE (1980EMBASE ( -2013, metaRegister, Cochrane Library and ISI conference proceedings was carried out. Results:Five randomised controlled trials with 192 patients receiving tranexamic acid and 196 controls were included. Metaanalysis demonstrated that mean estimated blood loss was significantly lower, and surgical field quality was significantly better in tranexamic acid group. There was no significant difference in mean operative time between the two groups. No significant adverse effects were noted in either of the groups. Conclusion:Intra-operative use of local and systemic tranexamic acid in ESS, results in significantly reduced estimated blood loss and improved surgical field quality. There is no statistically significant difference seen in operative time and incidence of side effects. Well-conducted larger RCTs using validated objective outcome measures and reporting on minor and major complications are required.

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“…Pooled data for postoperative bleeding showed no bleeding out of 66 cases, and one case of bleeding out of 66 controls (32,33,36) .…”

Section: Adverse Effectsmentioning

confidence: 97%

Section: Adverse Effectsmentioning

confidence: 97%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Estimated Blood Loss (Ebl)mentioning

confidence: 99%

See 3 more Smart Citations

Role of tranexamic acid in endoscopic sinus surgery - A systematic review and meta-analysis

Pundir¹,

Pundir²,

Georgalas

et al. 2013

Rhin

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Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality

et al. 2021

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IMPORTANCE Tranexamic acid (TXA) is an efficient antifibrinolytic agent; however, concerns remain about the potential adverse effects, particularly vascular occlusive events, that may be associated with its use.OBJECTIVE To examine the association between intravenous TXA and total thromboembolic events (TEs) and mortality in patients of all ages and of any medical disciplines.DATA SOURCE Cochrane Central Register of Controlled Trials and MEDLINE were searched for eligible studies investigating intravenous TXA and postinterventional outcome published between 1976 and 2020.STUDY SELECTION Randomized clinical trials comparing intravenous TXA with placebo/no treatment. The electronic database search yielded a total of 782 studies, and 381 were considered for full-text review. Included studies were published in English, German, French, and Spanish. Studies with only oral or topical tranexamic administration were excluded.DATA EXTRACTION AND SYNTHESIS Meta-analysis, subgroup and sensitivity analysis, and meta-regression were performed. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. MAIN OUTCOMES AND MEASURES Vascular occlusive events and mortality.RESULTS A total of 216 eligible trials including 125 550 patients were analyzed. Total TEs were found in 1020 (2.1%) in the group receiving TXA and 900 (2.0%) in the control group. This study found no association between TXA and risk for total TEs (risk difference = 0.001; 95% CI, −0.001 to 0.002; P = .49) for venous thrombosis, pulmonary embolism, venous TEs, myocardial infarction or ischemia, and cerebral infarction or ischemia. Sensitivity analysis using the risk ratio as an effect measure with (risk ratio = 1.02; 95% CI, 0.94-1.11; P = .56) and without (risk ratio = 1.03; 95% CI, 0.95-1.12; P = .52) studies with double-zero events revealed robust effect size estimates. Sensitivity analysis with studies judged at low risk for selection bias showed similar results. Administration of TXA was associated with a significant reduction in overall mortality and bleeding mortality but not with nonbleeding mortality. In addition, an increased risk for vascular occlusive events was not found in studies including patients with a history of thromboembolism. Comparison of studies with sample sizes of less than or equal to 99 (risk difference = 0.004; 95% CI, −0.006 to 0.014; P = .40), 100 to 999 (risk difference = 0.004; 95% CI, −0.003 to 0.011; P = .26), and greater than or equal to 1000 (risk difference = −0.001; 95% CI, −0.003 to 0.001; P = .44) showed no association between TXA and incidence of total TEs. Meta-regression of 143 intervention groups showed no association between TXA dosing and risk for venous TEs (risk difference, −0.005; 95% CI, −0.021 to 0.011; P = .53).CONCLUSIONS AND RELEVANCE Findings from this systematic review and meta-analysis of 216 studies suggested that intravenous TXA, irrespective of dosing, is not associated with increased risk of any TE. These results help clarify the incidence of...

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Tranexamic acid for patients with nasal haemorrhage (epistaxis)

Joseph

Martinez‐Devesa

Bellorini

et al. 2018

Cochrane Database of Systematic Reviews

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The effect of intravenous tranexamic acid on blood loss and surgical field quality during endoscopic sinus surgery: a placebo-controlled clinical trial

Cited by 64 publications

References 17 publications

Role of tranexamic acid in endoscopic sinus surgery - A systematic review and meta-analysis

Role of tranexamic acid in endoscopic sinus surgery - A systematic review and meta-analysis

Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality

Tranexamic acid for patients with nasal haemorrhage (epistaxis)

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