DOES INTRAVENOUS TRANEXAMIC ACID REDUCE BLOOD LOSS DURING SURGICALLY ASSISTED RAPID PALATAL EXPANSION?

Year 2017, Volume: 51 Issue: 3, 32 - 37, 02.10.2017

Emine Akbaş , Erol Cansız , Sabri Cemil İşler , Sırmahan Çakarer , Zerrin Çebi

https://izlik.org/JA84XN52YD

Abstract

Purpose: The purpose of this study was to evaluate the efficacy of tranexamic acid (TXA) in reducing blood loss during surgically assisted rapid palatal expansion (SARPE) procedure.

Subjects and Methods: A total of 34 patients (12 male, 22 female) who had been treated surgically under general anesthesia with SARPE including pterygoid disjunction for transverse maxillary deficiency (TMD) were included in this study. The study group (n=17) received intravenous (IV) TXA 10 mg/kg as a preoperative bolus; the control group (n=17) received normal saline solution. Preoperative and postoperative haemoglobin and haematocrit values, intraoperative blood loss, and any blood product transfusion were recorded.

Results: Blood loss during SARPE was statistically significantly less in the study group than the control group (p=0.0001).

Conclusion: Preoperative IV administration of TXA can effectively control blood loss during when SARPE with pterygoid disjunction is performed.

Keywords

Hemorrhage , maxillary expansion; SARPE; tranexamic acid; blood loss

References

• Handelman CS. Nonsurgical rapid maxillary alveolar expansion in adults: A clinical evaluation. Angle Orthod 1997;67(4):291-305; discussion 306-298.
• Verlinden CR, Gooris PG, Becking AG. Complications in transpalatal distraction osteogenesis: A retrospective clinical study. J Oral Maxillofac Surg 2011;69(3):899-905.
• Babacan H, Sokucu O, Doruk C, Ay S. Rapid maxillary expansion and surgically assisted rapid maxillary expansion effects on nasal volume. Angle Orthod 2006;76(1):66-71.
• Greenbaum KR, Zachrisson BU. The effect of palatal expansion therapy on the periodontal supporting tissues. Am J Orthod 1982;81(1):12-21.
• Haas AJ. Long-term posttreatment evaluation of rapid palatal expansion. Angle Orthod 1980;50(3):189-217.
• Langford SR, Sims MR. Root surface resorption, repair, and periodontal attachment following rapid maxillary expansion in man. Am J Orthod 1982;81(2):108-115.
• Lanigan DT, Mintz SM. Complications of surgically assisted rapid palatal expansion: Review of the literature and report of a case. J Oral Maxillofac Surg 2002;60(1):104-110.
• Mommaerts MY. Transpalatal distraction as a method of maxillary expansion. Br J Oral Maxillofac Surg 1999;37(4):268-272.
• Song G, Yang P, Hu J, Zhu S, Li Y, Wang Q. The effect of tranexamic acid on blood loss in orthognathic surgery: A meta-analysis of randomized controlled trials. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115(5):595-600.
• Timms DJ. A study of basal movement with rapid maxillary expansion. Am J Orthod 1980;77(5):500-507.
• Hynes M, Calder P, Scott G. The use of tranexamic acid to reduce blood loss during total knee arthroplasty. Knee 2003;10(4):375-377.
• Ho KM, Ismail H. Use of intravenous tranexamic acid to reduce allogeneic blood transfusion in total hip and knee arthroplasty: A meta-analysis. Anaesth Intensive Care 2003;31(5):529-537.
• Neilipovitz DT. Tranexamic acid for major spinal surgery. Eur Spine J 2004;13 Suppl 1:S62-65.
• Laupacis A, Fergusson D. Drugs to minimize perioperative blood loss in cardiac surgery: Meta-analyses using perioperative blood transfusion as the outcome. The international study of peri-operative transfusion (ISPOT) investigators. Anesth Analg 1997;85(6):1258-1267.
• Dunn CJ, Goa KL. Tranexamic acid: A review of its use in surgery and other indications. Drugs 1999;57(6):1005-1032.
• Patatanian E, Fugate SE. Hemostatic mouthwashes in anticoagulated patients undergoing dental extraction. Ann Pharmacother 2006;40(12):2205-2210.
• Sethna NF, Zurakowski D, Brustowicz RM, Bacsik J, Sullivan LJ, Shapiro F. Tranexamic acid reduces intraoperative blood loss in pediatric patients undergoing scoliosis surgery. Anesthesiology 2005;102(4):727-732.
• Andersson L, Nilsoon IM, Colleen S, Granstrand B, Melander B. Role of urokinase and tissue activator in sustaining bleeding and the management thereof with eaca and amca. Ann N Y Acad Sci 1968;146(2):642-658.
• Senghore N, Harris M. The effect of tranexamic acid (cyclokapron) on blood loss after third molar extraction under a day case general anaesthetic. Br Dent J 1999;186(12):634-636.
• Karimi A, Mohammadi SS, Hasheminasab M. Efficacy of tranexamic acid on blood loss during bimaxilary osteotomy: A randomized double blind clinical trial. Saudi J Anaesth 2012;6(1):41-45.
• Sankar D, Krishnan R, Veerabahu M, Vikraman B. Evaluation of the efficacy of tranexamic acid on blood loss in orthognathic surgery. A prospective, randomized clinical study. Int J Oral Maxillofac Surg 2012;41(6):713-717.
• Borea G, Montebugnoli L, Capuzzi P, Magelli C. Tranexamic acid as a mouthwash in anticoagulant-treated patients undergoing oral surgery. An alternative method to discontinuing anticoagulant therapy. Oral Surg Oral Med Oral Pathol 1993;75(1):29-31.
• Carter G, Goss A. Tranexamic acid mouthwash--a prospective randomized study of a 2-day regimen vs 5-day regimen to prevent postoperative bleeding in anticoagulated patients requiring dental extractions. Int J Oral Maxillofac Surg 2003;32(5):504-507.
• Carter G, Goss A, Lloyd J, Tocchetti R. Tranexamic acid mouthwash versus autologous fibrin glue in patients taking warfarin undergoing dental extractions: A randomized prospective clinical study. J Oral Maxillofac Surg 2003;61(12):1432-1435.
• Ramstrom G, Sindet-Pedersen S, Hall G, Blomback M, Alander U. Prevention of postsurgical bleeding in oral surgery using tranexamic acid without dose modification of oral anticoagulants. J Oral Maxillofac Surg 1993;51(11):1211-1216.
• Sindet-Pedersen S, Ramstrom G, Bernvil S, Blomback M. Hemostatic effect of tranexamic acid mouthwash in anticoagulant-treated patients undergoing oral surgery. N Engl J Med 1989;320(13):840-843.
• Souto JC, Oliver A, Zuazu-Jausoro I, Vives A, Fontcuberta J. Oral surgery in anticoagulated patients without reducing the dose of oral anticoagulant: A prospective randomized study. J Oral Maxillofac Surg 1996;54(1):27-32; discussion 323.
• Zellin G, Rasmusson L, Palsson J, Kahnberg KE. Evaluation of hemorrhage depressors on blood loss during orthognathic surgery: A retrospective study. J Oral Maxillofac Surg 2004;62(6):662-666.
• Robl MT, Farrell BB, Tucker MR. Complications in orthognathic surgery: A report of 1,000 cases. Oral Maxillofac Surg Clin North Am 2014;26(4):599-609.
• Hamedi Sangsari A, Sadr-Eshkevari P, Al-Dam A, Friedrich RE, Freymiller E, Rashad A. Surgically assisted rapid palatomaxillary expansion with or without pterygomaxillary disjunction: A systematic review and meta-analysis. J Oral Maxillofac Surg 2016;74(2):338-348.
• Kilic E, Kilic B, Kurt G, Sakin C, Alkan A. Effects of surgically assisted rapid palatal expansion with and without pterygomaxillary disjunction on dental and skeletal structures: A retrospective review. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115(2):167-174.
• Choi WS, Irwin MG, Samman N. The effect of tranexamic acid on blood loss during orthognathic surgery: A randomized controlled trial. J Oral Maxillofac Surg 2009;67(1):125-133.
• Eriksson O, Kjellman H, Pilbrant A, Schannong M. Pharmacokinetics of tranexamic acid after intravenous administration to normal volunteers. Eur J Clin Pharmacol 1974;7(5):375-380.