The efficacy of tranexamic acid in intra operative bleeding and post operative eyelid edema and peri orbital ecchymosis in Rhinoplasty surgery

Abstract

Rhinoplasty is one of the prevalent surgeries and because of its cosmetic nature, controlling it's complications is one of the challenging issues. Although the effect of tranxamic acid on intra operative bleeding has been proved in different surgeries, comprehensive and sufficient studies have not been made on the effect of this drug on intra operative bleeding and post operative eyelid edema, peri orbital echymosis and satisfaction rate of surgeon. This study aims to measure the effect of tranxamic acid on intra operative bleeding and post operative eyelid edema, per orbital ecchymosis and satisfaction rate of surgeon from surgery field. Patients and methods: In this study 60 consecutive patient randomly entered and divided in to intervention group and control group. Patients of intervention group received 10 mg/kg tranxamic acid exactly before operation in addition to routine treatments and then intra operative bleeding was measured through clinical calculations by gravimetry method and calculating the differential rate of pre-and postoperative hemoglobin and hematocrit. Then the rate of eyelid edema and peri orbital echymosis, and satisfaction rate of surgeon from surgery field were measured by 4-grade scoring tool and asking questions from the surgeon, respectively. The analysis of data was done by software SPSS. 20, and p value less than 0.05 was considered significant from statistical point of view. Findings: In the present study, clinical bleeding rate in intervention and control groups were 21356 ml and 25455 ml, resoectively, and this effect was considered significant from statistical point of view (P=0.013). Also bleeding rate calculated through pre- and postoperative hematocrit was significant (p=0.035), but our intervention had no statistical effect on bleeding calculated by pre E and post operative hemoglobin. The effect of tranamic acid on eyelid edema (p=0.03), peri orbital ecchymosis (p=0.04) and satisfaction of surgeon (p=0.035) was statistically significant Discussion: Considering various studies, effect of steroid drugs on complication reduction after rhinoplasty has been proved, but with respect to considerable effects of these drugs, using tranxamic acid can help to reduce rhinoplasty effects, and based on various studies in this fields, we can introduce new and less complicated methods for controlling the effects of elective surgeries such as rhinoplasty .