Use of preoperative tranexamic acid in tonsillectomy with or without adenoidectomy to reduce primary haemorrhage

Abstract

Background: Haemorrhage during adenotonsillectomy is a common and potentially grave complication especially in children due to less physiological compensation of total blood volume. Tranexamic acid being synthetic antifibrinolytic drug has been widely used in surgical procedures to reduce bleeding. Few researches have done to see its effectiveness during adenotonsillectomy. The objective of current study is to evaluate the use of preoperative tranexamic acid to reduce primary haemorrhage in children who undergo elective tonsillectomy with or without adenoidectomy. Subjects and methods: It was a It was a quantitative, randomized control study and conducted at Pakistan Railway hospital from June 2015 to September 2016.The current study included 80 children randomized into two groups. Children between the ages of 5 to 15 years had been operated for tonsillectomy with or without adenoidectomy. Group 1 (experimental group) was given tranexamic acid at a dose of 10mg/kg of body weight intravenously, 30 minutes before induction of anaesthesia while the other arm (control arm) did not receive injection tranexamic acid. All children underwent dissection and snare method under general anaesthesia. P-value were obtained by applying independent sample t-test and considered statistically significant at 0.05 in reduction of primary haemorrhage during the procedure. Results: In study group mean amount of primary haemorrhage was 64.56 (+40.85) ml and in control group was 98.34 (+62.57) ml. The comparison of Boezzart blood grading scale was also significantly different between both groups. Conclusion: Preoperative tranexamic acid when used intravenously is effective in reducing primary haemorrhage during tonsillectomy with or without adenoidectomy.