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Does tranexamic acid improve intra-operative visualisation in endoscopic ear surgery? A double-blind, randomised, controlled trial

Published online by Cambridge University Press:  13 November 2019

A Das ,
S Mitra ,
D Ghosh ,
S Kumar  and
A Sengupta
A Das
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
S Mitra*
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
D Ghosh
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
S Kumar
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
A Sengupta
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
*
Author for correspondence: Dr Sandipta Mitra, Department of Otorhinolaryngology and Head Neck Surgery, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, 244 AJC Bose Road, Kolkata 700020, India E-mail: [email protected]
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Abstract

Objective

To assess the effect of tranexamic acid on intra-operative bleeding and surgical field visualisation.

Methods

Fifty patients undergoing various endoscopic ear surgical procedures, including endoscopic tympanoplasty, endoscopic atticotomy or mastoidectomy, endoscopic ossiculoplasty, and endoscopic stapedotomy, were randomly assigned to: a study group that received tranexamic acid or a control group which received normal saline. The intra-operative bleeding and operative field visualisation was graded using the Das and Mitra endoscopic ear surgery bleeding and field visibility score, which was separately analysed for the external auditory canal and the middle ear.

Results

The Das and Mitra score was better (p < 0.05) in the group that received tranexamic acid as a haemostat when working in the external auditory canal; with respect to the middle ear, no statistically significant difference was found between the two agents. Mean values for mean arterial pressure, heart rate and surgical time were comparable in both groups, with no statistically significant differences.

Conclusion

Tranexamic acid appears to be an effective haemostat in endoscopic ear surgery, thus improving surgical field visualisation, especially during manipulation of the external auditory canal soft tissues.

Keywords

Otologic Surgical ProceduresEndoscopyHemorrhageTranexamic Acid
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 12 , December 2019 , pp. 1033 - 1037
Copyright
Copyright © JLO (1984) Limited, 2019

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Footnotes

Dr S Mitra takes responsibility for the integrity of the content of the paper

References

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