Effect of Tranexamic Acid Irrigation on Perioperative Blood Loss During Orthognathic Surgery: A Double-Blind, Randomized Controlled Clinical Trial

Purpose: Perioperative hemorrhage is an important concern during orthognathic surgery. The purpose of this study was to assess the effect of tranexamic acid (TXA) irrigation on perioperative hemorrhage during orthognathic surgery. Materials and Methods: In this double-blind, randomized controlled clinical trial, 56 participants who underwent orthognathic surgery were divided into 2 groups. The patients in the first group received TXA irrigation with normal saline (1 mg/mL), and the patients in the second group had normal saline for irrigation during orthognathic surgery. Age, gender, operation duration, the amount of irrigation solution used, and preoperative hemoglobin, hematocrit, and weight were the variables that were studied. The use of TXA solution for irrigation was the predictive factor of the study. Results: Each group consisted of 28 patients. Group 1 consisted of 15 male patients (53.6%) and 13 female patients (46.4%) and group 2 consisted of 14 male patients (50%) and 14 female patients (50%). There was no difference in the distributions of the variables between the 2 groups, except for the duration of the operation. The mean duration of the operation was 3.94 +/- 0.61 hours in group 1 and 4.17 +/- 0.98 hours in group 2, and the difference in this respect between the 2 groups was statistically significant (P < .05). The mean intraoperative blood loss was 817.85 +/- 261.83 mL in group 1 and 575.00 +/- 286.90 mL in group 2 (P < .05). The mean volume of irrigation was 1,057.14 +/- 407.04 mL in group 1 and 843.57 +/- 275.48 mL in group 2 (P > .05). Conclusions: TXA is effective in reducing intraoperative blood loss in patients for whom substantial blood loss is anticipated. (C) 2015 American Association of Oral and Maxillofacial Surgeons