Low-dose tranexamic acid in orthognathic surgery: two-dose protocol-a double-blind randomized controlled trial on oedema, bleeding, and visibility of the surgical field.

G Kaşarcıoğlu, T Pergel, E F Akkoyun, D Dolanmaz
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Abstract

The aim of this double-blind randomized controlled trial was to evaluate the effects of a two-dose tranexamic acid (TXA) protocol on oedema, bleeding, and surgical field visibility during orthognathic surgery. 72 patients participated and were assigned to three groups: the TXA250 group received a single intravenous dose of 250 mg TXA prior to incision; the TXA500 group received 250 mg TXA before incision and 250 mg after the first jaw surgery was completed; the control group received no TXA. Oedema was measured preoperatively and on postoperative days 1, 3, and 7. Sixty-four patients completed the study. Bleeding was significantly higher and Fromme scale scores for surgical field visibility were significantly lower in the control group compared to the TXA groups (all P < 0.001). The TXA500 group demonstrated significantly reduced oedema compared to the control group (day 3: P = 0.037, day 7: P = 0.002), while the comparison of the TXA250 and control groups showed no significant difference. However, there was no significant difference in oedema between the two TXA groups. Hence, no firm conclusions can be drawn about the superiority of two-dose TXA over the single dose; this needs further investigation in a future study.

低剂量氨甲环酸在正颌手术中的应用:双剂量方案——一项关于水肿、出血和手术视野可见度的双盲随机对照试验。
这项双盲随机对照试验的目的是评估双剂量氨甲环酸(TXA)方案对正颌手术中水肿、出血和手术视野可见度的影响。72例患者被分为三组:TXA250组在切开前单次静脉注射250mg TXA;TXA500组切口前给予TXA 250 mg,第一次颌部手术后给予TXA 250 mg;对照组不给予TXA。术前及术后第1、3、7天测量水肿。64名患者完成了这项研究。与TXA组相比,对照组出血明显增加,手术视野可见度的Fromme评分明显降低(均P < 0.001)。与对照组相比,TXA500组水肿明显减轻(第3天:P = 0.037,第7天:P = 0.002),而TXA250组与对照组比较无显著差异。然而,两个TXA组在水肿方面没有显著差异。因此,没有确切的结论可以得出两剂TXA优于单剂;这需要在未来的研究中进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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