تاثیر دوز پروفیلاکتیک ترانکسامیک اسید در میزان خونریزی در جراحیهای فک تحتانی: مطالعه کارآزمایی بالینی تصادفی دوسو کور

Abstract: Aims and Background: Tranexamic acid has been used to reduce blood loss and the need for blood transfusion in many surgeries. Traumatic mandibular surgeries can be associated with significant bleeding which affects the field of operation and creates difficulties for the surgeon. Therefore we decided to evaluate the effect of tranexamic acid on the amount of bleeding during traumatic mandibular surgeries. Methods and Materials: In this randomized double blinded clinical trail, 90 patients, scheduled for traumatic mandibular surgeries with ASA class I-II and aged between 18 to 40 years, were included. They were randomly assigned to each group (n=45). After induction of general anesthesia with the same plan they received tranexamic acid (10mg/kg) or equal volume of normal saline, intravenously. Intra operative bleeding, pre-op hemoglobin (Hb), hematocrit (Hct) concentration, post-op (after 6 hours) Hb and Hct concentration, rate of blood transfusion and the quality of surgical field were recorded for each patient. Then data analyisis was performed with (SPSS software version 16). Findings: Mean intraoperative bleeding in the tranexamic acid and placebo group were 80.44± 49.43ml and 183.0 ± 69.53ml, respectively (P=0.0001). Post-op decreasing rate of Hb and Hct were less in the tranexamic acid group vs. the control one(P=0.0001 for Hb , P=0.001 for Hct). The Quality of surgical field leading to the surgeon’s satisfaction was better in the tranexamic group than the control group. (P=0.0001). None of the patients needed blood transfusion. Adverse effects were not seen in any of the groups. Conclusions: Administration of IV tranexamic acid decreases the amount of bleeding during mandibular surgeries. Keywords: Tranexamic acid, Bleeding, Mandibular surgery, Hemoglobin, Hematocrit