Role of Tranexamic Acid in Intraoperative Blood Loss and Postoperative Edema and Ecchymosis in Primary Elective Rhinoplasty: A Randomized Controlled Trial

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Author(s): Muhammad Raza Tahir,1 Farrukh Aslam Khalid,2 Muhammad Amin,3 Maruf Zahid,4 Rida Naeem,5 Hafsa Khalid6

Received: 15/03/3024 | Revised: 23/06/2024 | Published: 24/06/2024 | Pages: 55-59 | DOI: https://doi.org/10.5455/pjps.17105242671224


Background: Rhinoplasty often involves significant bleeding and postoperative complications. Tranexamic acid (TXA) may reduce these issues. This study evaluates the effect of preoperative TXA on blood loss, surgery duration, and postoperative complications in rhinoplasty patients.

Objective: To compare blood loss during surgery, edema, and ecchymosis after surgery in patients administered with TXA or normal saline undergoing primary elective rhinoplasty.

Methodology: Sixty-eight patients requiring rhinoplasty were included in this randomized control trial (RCT). Thirty-four patients received TXA 20 ml preoperatively (Group-A) while thirty-four received 0.9% normal saline (Group-B). Outcomes between both groups were assessed in terms of surgery duration, intraoperative bleeding, edema, and ecchymosis between both groups.

Results: All the patients completed the study. The mean age in group A was 33.59±9.25 years while 31.21±9.22 years in group B. The duration of surgery in group A turned out to be 103.38±10.37 mins while in group B it was 120±11.31 mins with notably reduced duration of surgery in group A(P = 0.0001). Group Ashowed notably lower intraoperative blood loss (148.88±30.75) ml as compared to the placebo group which received normal saline (180.44±24.75 ml, P = 0.0001). The incidence of postoperative edema and ecchymosis compared to the placebo group was significantly lower.

Conclusion: Preoperative tranexamic acid lowers postoperative side effects such as edema and ecchymosis and greatly reduces blood loss and shortens surgery duration in patients undergoing rhinoplasty.

Keywords | Rhinoplasty, Edema, Blood loss, Tranexamic acid, Ecchymosis