Department of OMFS, Ragas Dental College and Hospital, India.
Int J Oral Maxillofac Surg. 2012 Jun;41(6):713-7. doi: 10.1016/j.ijom.2012.01.008. Epub 2012 Feb 15.
The purpose of this prospective, randomized, double blind study was to assess the effect of tranexamic acid on blood loss, quality of surgical field and duration of surgery in adolescent orthognathic surgery patients. 50 consecutive patients, scheduled for orthognathic surgery were included. The study group (n=25) received tranexamic acid 10mg/kg as a bolus preoperatively followed by 1mg/kg as a maintenance dose intra operatively; the control group (n=25) received placebo (normal saline). All patients received moderate hypotensive anaesthesia with nitroglycerin and had surgery according to a standard protocol. Intra operative blood loss, duration of surgery, quality of surgical field, blood transfusion and complications, if any, were recorded. The mean total blood loss was 166.1±65.49ml in the study group and 256.4±77.80ml in the control group. The results showed statistically significant reduction in blood loss (p<0.001) and improved quality of surgical field (p<0.001) in the study group. There was no significant difference in duration of surgery and transfusion requirements between the two groups. In conclusion, preoperative and intra operative administration of the antifibrinolytic agent, tranexamic acid, is effective in controlling blood loss and improving the quality of the surgical field.
本前瞻性、随机、双盲研究的目的是评估氨甲环酸对青少年正颌手术患者术中失血量、手术视野质量和手术时间的影响。纳入了 50 例连续接受正颌手术的患者。研究组（n=25）患者术前给予氨甲环酸 10mg/kg 作为负荷剂量，然后术中给予 1mg/kg 维持剂量；对照组（n=25）患者给予安慰剂（生理盐水）。所有患者均接受硝酸甘油控制性低血压麻醉，并按照标准方案进行手术。记录术中失血量、手术时间、手术视野质量、输血情况和任何并发症。研究组的平均总失血量为 166.1±65.49ml，对照组为 256.4±77.80ml。结果显示，研究组术中失血量显著减少（p<0.001），手术视野质量显著改善（p<0.001）。两组手术时间和输血需求无显著差异。总之，术前和术中应用抗纤维蛋白溶解剂氨甲环酸可有效控制失血量并改善手术视野质量。
