Tranexamic acid in head and neck procedures: a systematic review and meta-analysis of randomized controlled trials

Alsubaie, Hemail M.; Abu‐Zaid, Ahmed; Sayed, Suhail I.; Pathak, Kalyani; Almayouf, Mohammed A.; Albarrak, Majed; Aldhahri, Saleh Fahed; Al‐Qahtani, Khalid

doi:10.1007/s00405-021-07132-6

Cited by 5 publications

(8 citation statements)

References 30 publications

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“…Therefore, it is possible that a few blood transfusions could have been avoided in the control group. The difference found in our study compared to the recent studies and even a relatively older meta-analysis is probably explained by the above facts [8,15].…”

Section: Discussioncontrasting

confidence: 99%

“…TXA has been used by many researchers to evaluate the impact on intraoperative blood loss and postoperative blood transfusion requirement in patients undergoing major surgeries like cardiac, orthopedics, and head and neck cancer surgery and found variable results [8,9,12]. One of the frequently observed non-homogeneity among the studies is the methods of blood loss estimation.…”

Section: Discussionmentioning

confidence: 99%

“…However, clinical studies done in a different group of patients show variable results [8,9]. Even the blood loss assessment varies a lot.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Two Different Tranexamic Acid Doses on Blood Loss in Head and Neck Cancer Surgery: A Randomized, Double-Blind, Controlled Study

Babu¹,

Neema²,

Karim³

et al. 2021

Cureus

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Background and aimHead and neck cancer is frequent, and surgeries pose more significant morbidity and mortality due to multitudinal causes; heavy blood loss and transfusion are among them. Tranexamic acid (TXA) is known to stabilize the micro clots hence controlling excessive blood loss. The present study aimed to compare perioperative blood loss with two different doses of TXA and placebo to find the effectiveness and optimal dose. MethodsWith ethical approvals and informed consent, the present prospective, randomized, double-blind, controlled study was conducted in a teaching institute from May 31, 2018, to Dec 28, 2019. Patients undergoing elective head and neck cancer (HNC) surgeries were included. Preoperative Hb < 7 gm% or > 16 gm%, known coagulopathy, anticoagulant therapy, contraindications to TXA, intraoperative torrential or blood loss due to arterial injury were excluded. Group T-1 received TXA 10mg/kg, T-II received 15 mg/kg, while the control group (Gr-C) received equal volume normal saline. Data about demography, surgical time, intraoperative and postoperative blood loss, and transfusion were collected and compared. SPSS software was used for analysis; p-value <0.05 was considered significant. ResultsNinety patients were screened, 84 completed the study. All three groups were similar in demographics. The median blood loss with 25 th -75 th percentile in group C, T-I, and T-II groups were 762.5 (513.5-1193), 541.5 (296.5-787), and 536.0 (180.5 -879) mL, respectively; p: 0.025. There was a significant difference between the control group and T-I (p-value: 0.0153), and control and T-II (p-value: 0.0248), but an insignificant difference between T-I and T-II (p-value: 0.706). 5 (17.85%) in each of T-I and T-II required transfusion, whereas 14 (50%) in the control group required it; p < 0.011). No major clinically significant related to study drugs were noted. ConclusionCompared to placebo (normal saline), preoperative administration of TXA in bolus significantly reduced perioperative blood losses and transfusion requirement in patients undergoing HNC surgery as estimated using the Hb-based method. A bolus dose of doses of 10mg/kg and 15 mg/kg is equally effective.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of Two Different Tranexamic Acid Doses on Blood Loss in Head and Neck Cancer Surgery: A Randomized, Double-Blind, Controlled Study

Babu¹,

Neema²,

Karim³

et al. 2021

Cureus

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“…[25] evaluated drain output on postoperative days 0 and 1, reporting average drainage to be 10–14 ml per drain on day 0 and 15 ml on day 1; subsequently, 92% of patients had their drains removed on POD1. Decreased drainage after employing TXA was also substantiated by a meta-analysis of head and neck procedures, which showed significant reduction in overall output [31 ▪ ].…”

Section: Clinical Effectsmentioning

confidence: 83%

Modern use of tranexamic acid in facial plastic surgery

Luetzenberg

Lyford-Pike

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review Although tranexamic acid is commonly used in surgical fields such as obstetrics, orthopedics, and trauma, its utilization in facial plastic surgery is a recently emerging concept, and studies examining its potential impact have been few. This review highlights how tranexamic acid may be employed during facial plastic procedures and the promising impact it may have. Recent findings Tranexamic acid is primarily being studied in rhinoplasties and rhytidectomies, with intravenous administration and local infiltration being the most common routs of application, respectively. During rhinoplasties, tranexamic acid has the potential to improve the visualization of the surgical field by decreasing blood loss and to improve postoperative edema and ecchymosis. For rhytidectomies, on the contrary, it may shorten time to attain hemostasis, lessen the rate of hematoma formation, and lead to lower surgical drain output. Its efficacy is preserved at low doses, and significant medication side effects have not been reported after facial plastic procedures. Summary Altogether, tranexamic acid may present a valuable adjuvant to facial plastic surgery, as it could increase both surgeon and patient satisfaction while exhibiting a benign safety profile.

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“… 17 Interest of TXA in head and neck surgery is controversial, with studies showing no effects on intraoperative blood loss, while other authors found a significant reduction in postoperative bleeding. 18 - 21 In rhinology and sinus surgery, several papers have pointed out the benefits of using TXA. 22 - 29 …”

Section: Discussionmentioning

confidence: 99%

Effects of Tranexamic Acid on Intraoperative Bleeding and Surgical Field Visualization During Middle Ear Surgery: A Narrative Review

Pontillo,

Daval,

Marc

et al. 2024

JIAO

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Tranexamic acid in head and neck procedures: a systematic review and meta-analysis of randomized controlled trials

Cited by 5 publications

References 30 publications

Effect of Two Different Tranexamic Acid Doses on Blood Loss in Head and Neck Cancer Surgery: A Randomized, Double-Blind, Controlled Study

Effect of Two Different Tranexamic Acid Doses on Blood Loss in Head and Neck Cancer Surgery: A Randomized, Double-Blind, Controlled Study

Modern use of tranexamic acid in facial plastic surgery

Effects of Tranexamic Acid on Intraoperative Bleeding and Surgical Field Visualization During Middle Ear Surgery: A Narrative Review

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