Eldaba Ahmed A, Amr Yasser Mohamed, Albirmawy Osama A
Department of Anesthesia and Surgical Intensive Care, Tanta University, Tanta, Egypt.
Saudi J Anaesth. 2013 Jul;7(3):229-33. doi: 10.4103/1658-354X.115314.
This study was conducted to evaluate the effect of tranexamic acid (TA) on the intra-operative bleeding during the functional endoscopic sinus surgery (FESS) in children.
A total of 100 children recruited to undergo FESS were randomized into two groups. Group I: Was given just after induction, intra-venous 25 mg/kg TA diluted in 10 ml of normal saline. Group II: Was given 10 ml of normal saline. Non-invasive blood pressure, heart rate, and quality of the surgical field were estimated every 15 min. Volume of bleeding and duration of the surgical procedure were recorded.
Surgical field quality after 15 min revealed that seven patients in group I had minimal bleeding versus no one in group II, P=0.006. Meanwhile, 35 patients in group I had mild bleeding versus 26 patients in group II, P=0.064. Higher number of patients in group II than in group I had moderate bleeding, P=0006. Also, at 30 min, revealed that 10 patients in group I had minimal bleeding versus one patient in group II, P=0.004. Meanwhile, 37 patients in group I had mild bleeding versus 28 patients in group II, P=0.059. Higher number of patients in group II than in group I had moderate bleeding, P<0001. Duration of the surgeries and volume of bleeding were significantly less in tranexamic group than the placebo group, P<0.0001.
Single intra-venous bolus dose of tranexamic in children during the FESS improves quality of surgical field, reduces intra-operative bleeding, and duration of surgery.
本研究旨在评估氨甲环酸(TA)对儿童功能性鼻内镜鼻窦手术(FESS)术中出血的影响。
总共100名招募接受FESS的儿童被随机分为两组。第一组:诱导后即刻静脉注射稀释于10ml生理盐水中的25mg/kg TA。第二组:给予10ml生理盐水。每15分钟评估无创血压、心率和手术视野质量。记录出血量和手术时长。
15分钟后的手术视野质量显示,第一组有7名患者出血极少,而第二组无一人如此,P = 0.006。同时,第一组有35名患者轻度出血,第二组有26名患者,P = 0.064。第二组中度出血的患者数量多于第一组,P = 0.006。此外,在30分钟时,显示第一组有10名患者出血极少,第二组有1名患者,P = 0.004。同时,第一组有37名患者轻度出血,第二组有28名患者,P = 0.059。第二组中度出血的患者数量多于第一组,P < 0.001。氨甲环酸组的手术时长和出血量显著少于安慰剂组,P < 0.0001。
在儿童FESS期间单次静脉推注氨甲环酸可改善手术视野质量,减少术中出血和手术时长。