Tranexamic acid in bleeding reduction and operative time of nasal surgeries: systematic review and meta-analysis.

Autor: Goncalves PE; Department of Medicine, Federal University of Sergipe, Claudio Batista St, Aracaju, SE, 49060-100, Brazil. pauloeduptc@gmail.com., Ferreira FJS; Department of Medicine, Federal University of Sergipe, Claudio Batista St, Aracaju, SE, 49060-100, Brazil., Lima AS; Department of Medicine, Federal University of Sergipe, Claudio Batista St, Aracaju, SE, 49060-100, Brazil., Moreira DC; Department of Neurosurgery, Hospital de Cirurgia, 174, Desembargador Maynard, Cirurgia, Aracaju, SE, Brazil., de Oliveira Santos BF; Department of Neurosurgery, Hospital de Cirurgia, 174, Desembargador Maynard, Cirurgia, Aracaju, SE, Brazil., Melo NAD; Department of Otolaryngology, Tiradentes University, 300, Murilo Dantas Avenue, Farolândia, Aracaju, SE, Brazil., Beer-Furlan A; Department of Skull Base and Endovascular Surgery, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, USA., Oliveira AMP; Department of Medicine, Federal University of Sergipe, Claudio Batista St, Aracaju, SE, 49060-100, Brazil.; Department of Neurosurgery, Hospital de Cirurgia, 174, Desembargador Maynard, Cirurgia, Aracaju, SE, Brazil.
Jazyk: angličtina
Zdroj: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2024 Mar; Vol. 281 (3), pp. 1105-1114. Date of Electronic Publication: 2023 Oct 21.
DOI: 10.1007/s00405-023-08291-4
Abstrakt: Purpose: Our study goal is to review the efficacy of tranexamic acid in reducing blood loss and operative time in nasal surgeries.
Methods: We included randomized clinical trials using oral or intravenous tranexamic acid, excluded non-randomized studies, topic administration, coagulopathy, and using other drugs interfering in the coagulation cascade. Online databases, National Library of Medicine (MEDLINE-PubMED), Latin American and Caribbean Literature on Health Sciences (Lilacs), Cochrane Library, Embase and Google Scholar were used to perform the search. The review was registered in PROSPERO by no CRD42022310977. Two authors, independently, selected the articles meeting the inclusion criteria. They extracted the data and used RevMan 5 software to perform the meta-analysis.
Results: Our search resulted in 16 RCTs that were included in the meta-analysis totalizing 1108 patients. Studies were evaluated resulting in a low risk of bias for the five domains. The use of tranexamic acid resulted in significant reduction in duration of surgery (DOS) and intraoperative blood loss (IBL) had significant reduction. The level of evidence according to GRADE System was high in all studies and variables.
Conclusion: Tranexamic acid has an important role in reducing intraoperative blood loss and duration of surgery. Our study has some limitations due to the low number of RCTs available in the literature.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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