Effects of Preoperative Intravenous Versus Subcutaneous Tranexamic Acid on Postoperative Periorbital Ecchymosis and Edema Following Upper Eyelid Blepharoplasty: A Prospective, Randomized, Double-Blinded, Placebo-Controlled, Comparative Study.

IF 1.2 4区 医学 Q3 OPHTHALMOLOGY
Charlotte L Marous, Omar J Farhat, Matthew Cefalu, Michael I Rothschild, Sailaja Alapati, Edward J Wladis
{"title":"Effects of Preoperative Intravenous Versus Subcutaneous Tranexamic Acid on Postoperative Periorbital Ecchymosis and Edema Following Upper Eyelid Blepharoplasty: A Prospective, Randomized, Double-Blinded, Placebo-Controlled, Comparative Study.","authors":"Charlotte L Marous, Omar J Farhat, Matthew Cefalu, Michael I Rothschild, Sailaja Alapati, Edward J Wladis","doi":"10.1097/IOP.0000000000002633","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effects of preoperative tranexamic acid (TXA) administered intravenously (IV) versus subcutaneously on postoperative ecchymosis and edema in patients undergoing bilateral upper eyelid blepharoplasty.</p><p><strong>Methods: </strong>A prospective, double-blinded, placebo-controlled study of patients undergoing bilateral upper eyelid blepharoplasty at a single-center. Eligible participants were randomized to preoperatively receive either (1) 1 g of TXA in 100 ml normal saline IV, (2) 50 µl/ml of TXA in local anesthesia, or (3) no TXA. Primary outcomes included ecchymosis and edema at postoperative day 1 (POD1) and 7 (POD7). Secondary outcomes included operative time, pain, time until resuming activities of daily living, patient satisfaction, and adverse events.</p><p><strong>Results: </strong>By comparison (IV TXA vs. local subcutaneous TXA vs. no TXA), ecchymosis scores were significantly lower on POD1 (1.31 vs. 1.56 vs. 2.09, p = 0.02) and on POD7 (0.51 vs. 0.66 vs. 0.98, p = 0.04) among those that received TXA. By comparison (IV TXA vs. local subcutaneous TXA vs. no TXA), significant reductions in edema scores occurred in those that received TXA on POD1 (1.59 vs. 1.43 vs. 1.91, p = 0.005) and on POD7 (0.85 vs. 0.60 vs. 0.99, p = 0.04). By comparison (IV TXA vs. local subcutaneous TXA vs. no TXA) patients treated with intravenous and local subcutaneous TXA preoperatively were more likely to experience shorter operative times (10.8 vs. 11.8 vs. 12.9 minutes, p = 0.01), reduced time to resuming activities of daily livings (1.6 vs. 1.6 vs. 2.3 days, p < 0.0001), and higher satisfaction scores at POD1 (8.8 vs. 8.7 vs. 7.9, p = 0.0002). No adverse events occurred were reported.</p><p><strong>Conclusion: </strong>In an analysis of 106 patients, preoperative TXA administered either IV or subcutaneously safely reduced postoperative ecchymosis and edema in patients undergoing upper eyelid blepharoplasty. While statistical superiority between intravenous versus local subcutaneous TXA treatment was not definitively identified, our results suggest clinical superiority with IV dosing.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmic Plastic and Reconstructive Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/IOP.0000000000002633","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/4/29 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: To compare the effects of preoperative tranexamic acid (TXA) administered intravenously (IV) versus subcutaneously on postoperative ecchymosis and edema in patients undergoing bilateral upper eyelid blepharoplasty.

Methods: A prospective, double-blinded, placebo-controlled study of patients undergoing bilateral upper eyelid blepharoplasty at a single-center. Eligible participants were randomized to preoperatively receive either (1) 1 g of TXA in 100 ml normal saline IV, (2) 50 µl/ml of TXA in local anesthesia, or (3) no TXA. Primary outcomes included ecchymosis and edema at postoperative day 1 (POD1) and 7 (POD7). Secondary outcomes included operative time, pain, time until resuming activities of daily living, patient satisfaction, and adverse events.

Results: By comparison (IV TXA vs. local subcutaneous TXA vs. no TXA), ecchymosis scores were significantly lower on POD1 (1.31 vs. 1.56 vs. 2.09, p = 0.02) and on POD7 (0.51 vs. 0.66 vs. 0.98, p = 0.04) among those that received TXA. By comparison (IV TXA vs. local subcutaneous TXA vs. no TXA), significant reductions in edema scores occurred in those that received TXA on POD1 (1.59 vs. 1.43 vs. 1.91, p = 0.005) and on POD7 (0.85 vs. 0.60 vs. 0.99, p = 0.04). By comparison (IV TXA vs. local subcutaneous TXA vs. no TXA) patients treated with intravenous and local subcutaneous TXA preoperatively were more likely to experience shorter operative times (10.8 vs. 11.8 vs. 12.9 minutes, p = 0.01), reduced time to resuming activities of daily livings (1.6 vs. 1.6 vs. 2.3 days, p < 0.0001), and higher satisfaction scores at POD1 (8.8 vs. 8.7 vs. 7.9, p = 0.0002). No adverse events occurred were reported.

Conclusion: In an analysis of 106 patients, preoperative TXA administered either IV or subcutaneously safely reduced postoperative ecchymosis and edema in patients undergoing upper eyelid blepharoplasty. While statistical superiority between intravenous versus local subcutaneous TXA treatment was not definitively identified, our results suggest clinical superiority with IV dosing.

术前静脉注射与皮下注射氨甲环酸对上睑眼睑成形术后眶周瘀斑和水肿的影响:一项前瞻性、随机、双盲、安慰剂对照比较研究。
目的:比较术前静脉注射氨甲环酸(TXA)与皮下注射氨甲环酸(TXA)对双侧上眼睑眼睑成形术患者术后瘀斑和水肿的影响:这是一项前瞻性、双盲、安慰剂对照研究,研究对象是在一家中心接受双侧上眼睑眼睑成形术的患者。符合条件的参与者在术前随机接受(1)100 毫升生理盐水静脉注射 1 克 TXA;(2)50 微升/毫升 TXA 局麻;或(3)不注射 TXA。主要结果包括术后第 1 天(POD1)和第 7 天(POD7)的瘀斑和水肿。次要结果包括手术时间、疼痛、恢复日常生活所需时间、患者满意度和不良事件:通过比较(静脉注射 TXA 与局部皮下注射 TXA 与不注射 TXA),接受 TXA 的患者在 POD1(1.31 vs. 1.56 vs. 2.09,p = 0.02)和 POD7(0.51 vs. 0.66 vs. 0.98,p = 0.04)的瘀斑评分明显降低。通过比较(静脉注射 TXA vs. 局部皮下注射 TXA vs. 不注射 TXA),在 POD1(1.59 vs. 1.43 vs. 1.91,p = 0.005)和 POD7(0.85 vs. 0.60 vs. 0.99,p = 0.04)接受 TXA 治疗的患者水肿评分显著降低。通过比较(静脉注射 TXA vs. 局部皮下注射 TXA vs. 不注射 TXA),术前接受静脉注射和局部皮下注射 TXA 治疗的患者更有可能缩短手术时间(10.8 vs. 11.8 vs. 12.9)。11.8 分钟 vs. 12.9 分钟,p = 0.01),恢复日常活动的时间缩短(1.6 天 vs. 1.6 天 vs. 2.3 天,p < 0.0001),POD1 满意度评分提高(8.8 分 vs. 8.7 分 vs. 7.9 分,p = 0.0002)。无不良事件报告:在对106名患者进行的分析中,术前静脉注射或皮下注射TXA可安全地减少上睑眼睑成形术患者的术后瘀斑和水肿。虽然静脉注射 TXA 与局部皮下注射 TXA 在统计学上没有明确的优劣之分,但我们的研究结果表明静脉注射 TXA 在临床上更具优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.50
自引率
10.00%
发文量
322
审稿时长
3-8 weeks
期刊介绍: Ophthalmic Plastic and Reconstructive Surgery features original articles and reviews on topics such as ptosis, eyelid reconstruction, orbital diagnosis and surgery, lacrimal problems, and eyelid malposition. Update reports on diagnostic techniques, surgical equipment and instrumentation, and medical therapies are included, as well as detailed analyses of recent research findings and their clinical applications.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信