Department of Anesthesiology, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Adv Clin Exp Med. 2012 Nov-Dec;21(6):773-80.
One of the main concerns in sinus surgery is blood loss due to the high vasculature of the mucosa. Tranexamic acid (TA) is an antifibrinolytic agent which reduces bleeding following certain surgical procedures.
This randomized double-blinded clinical trial was performed on 70 patients with class I and II ASA (American Society of Anesthesiologists) who were scheduled for endoscopic sinus surgery under general anesthesia. The average ages of the patients were 18 to 50 years old. Thirty-five patients (group A) received 5 mg/Kg of TA, and another 35 patients (group B) received 15 mg/Kg of TA. The mean arterial pressure (MAP), diastolic blood pressure (DBP), systolic blood pressure (SBP) and heart rate (HR) were documented. Also, the amount of blood loss and satisfaction scores were obtained from the surgeon in 30th, 60th, 90th, 120th and 180th minutes. All the data was analyzed by SPSS-15 software with T-test.
A total of 52 males and 18 females participated in the study. There were no significant differences between the mean age, MAP, DBP, SBP and HR during surgery between groups. Blood loss was 272.74 ± 25.77 mL 242.89 ± 51.77 mL in the group A and B respectively (P < 0.003). The surgeon was more satisfied with the surgical field of the group B than the group A (mean scores 4 (3-5) vs. 3 (1-5) respectively, P < 0.005). Surgery period and need for supplement drug to control bleeding in group B was significantly less than in group A (P < 0.05). But there was no significant difference between the two groups in terms of side effects.
Administration of 15 mg/Kg TA intravenously is more effective than 5 mg TA to achieve hemostasis and improving the quality of surgical field, surgeon satisfaction, less surgery period and bleeding volume during endoscopic sinus surgery without any significant side effects.
鼻窦手术中主要关注的问题之一是由于粘膜血管丰富导致的失血。氨甲环酸（TA）是一种抗纤维蛋白溶解剂，可减少某些手术程序后的出血。
这项随机双盲临床试验在 70 名 ASA 分级 I 和 II 级（美国麻醉医师协会）的患者中进行，这些患者在全身麻醉下接受内窥镜鼻窦手术。患者的平均年龄为 18 至 50 岁。35 名患者（A 组）接受 5mg/Kg 的 TA，另 35 名患者（B 组）接受 15mg/Kg 的 TA。记录平均动脉压（MAP）、舒张压（DBP）、收缩压（SBP）和心率（HR）。此外，从外科医生那里获得 30 分钟、60 分钟、90 分钟、120 分钟和 180 分钟时的出血量和满意度评分。所有数据均使用 SPSS-15 软件进行 T 检验分析。
共有 52 名男性和 18 名女性参与了这项研究。两组之间手术过程中的平均年龄、MAP、DBP、SBP 和 HR 没有显著差异。A 组和 B 组的出血量分别为 272.74 ± 25.77ml 和 242.89 ± 51.77ml（P < 0.003）。外科医生对 B 组的手术视野比 A 组更满意（平均评分分别为 4（3-5）和 3（1-5），P < 0.005）。B 组的手术时间和需要补充药物控制出血的情况明显少于 A 组（P < 0.05）。但两组在副作用方面无显著差异。
静脉注射 15mg/Kg TA 比 5mg TA 更有效，可达到止血效果，改善手术视野质量，提高外科医生满意度，减少手术时间和出血量，而无明显副作用。
