The efficacy of low dose intravenous tranexamic acid on intraoperative blood loss in bimaxillary surgery

Abstract

ObjectiveThe aim of this study was to identify the effect of tranexamic acid on intraoperative blood loss during bimaxillary surgery. MethodsA retrospective cohort study was performed in patients underwent bimaxillary osteotomy under hypotensive anesthesia with nicardipine. Twenty eight patients were divided into two groups, a standard group did not receive tranexamic acid, a study group​ received a single dose of 10 mg/kg of tranexamic acid, preoperatively. The operation and​ surgeons were matched in​ both groups. General anesthesia was performed by one anesthesiologist. Data collection included the operation time, preoperative hematocrit, postoperative hematocrit, intraoperative blood loss, and any blood transfusion. The analysis were divided into two sub groups, a total osteotomy of Le Fort I with mandibular surgery, and a segmented osteotomy of Le Fort I with mandibular surgery. ResultThe intraoperative blood loss during bimaxillary surgery in the study group was lower than the standard group but​ without statistical significant difference(664.29±213.42 mL vs 850.00±356.26 mL)​(P = 0.05). The intraoperative blood loss and blood transfusion during segmented osteotomy of Le Fort I with mandibular surgery was reduced significantly in the study group compared with the standard group(650.00±217.94 mL vs 1,092.86±346.92 mL and 0.71±0.95 units vs 1.57±0.78 units)(P < 0.05). There were no complications such as nausea, vomiting and other complications in any of the patients. ConclusionA single preoperative intravenous administration of 10 mg/kg of tranexamic acid is effective and safe in controlling blood loss in segmented osteotomy of Le Fort I with mandibular surgery.