Background and Objective: Post-tonsillectomy bleeding is a significant concern in otolaryngological surgeries. Tranexamic acid has been extensively studied for its role in reducing bleeding, particularly in surgical settings. This study aimed to evaluate the efficacy of tranexamic acid in controlling bleeding in patients undergoing adenotonsillectomy.
Methods: A randomized clinical trial was conducted on 160 patients aged 6 to 14 years, who were candidates for tonsillectomy at the Ear, Nose, and Throat Clinic of Khatam Al-Anbiya Hospital in Zahedan in 2017. Patients were randomly divided into two groups of 80 each (case and control). The intervention group received intravenous tranexamic acid (TXA; 10 mg/kg, TRANEXIP®) administered as follows: an initial dose 5 minutes prior to surgical incision, followed by subsequent doses every 6 hours for 48 hours postoperatively. The volume of bleeding during surgery, as well as 24 hours and two weeks post-surgery, was recorded for all patients.
Findings: The mean volume of intraoperative bleeding in the case group (receiving tranexamic acid) was 44.18± 11.67 ml, compared to 55.62±20.93 ml in the control group. This difference was statistically significant (p<0.001). Postoperative bleeding was reported in only two cases, both in the control group. The mean heart rate in the case group was 92.82±12.15, and in the control group, it was 96.12±13.42, but this difference was not statistically significant (p=0.105).
Conclusion: The findings of this study indicate that tranexamic acid significantly reduces the volume of intraoperative bleeding in patients undergoing adenotonsillectomy.