Abstract

Background: Orthognathic surgery is performed for the correction of dentofacial deformities which can result in significant bleeding from both incised soft tissues as well as bones, during the procedure and postoperatively due to the high vascularity of the maxillofacial region. Tranexamic acid (TA) is a drug with anti-fibrinolytic activity which helps in reducing the blood loss.

Aims: The main objective of the study is to evaluate the effect of intravenous TA on perioperative blood loss during orthognathic surgery in adult patients. Also the study is to assess the blood loss during surgery and the changes in hemoglobin and hematocrit in the both groups before and after surgery.

Settings and Design: prospective, randomized, double blind, control study

Methods and Material: ASA-I and ASA-II patients, between age 18 – 45 years, undergoing orthognathic surgery were divided in to two groups. Group A received TA 20mg/kg over 20 minutes in 100 ml normal saline 15 minutes before incision and Group B received equal amount of normal saline comprised a total of 52 patients in each group. Clinical parameters like counting the number of mops, gauzes and weighing them, blood in the suction, perioperative hemoglobin and hematocrit will be assessed.

Statistical analysis used: Collected data was analyzed by both descriptive and inferential statistical methods. Data was summarized by frequency percentage mean and standard deviation. To compare between two groups with respective and various quantitative parameters independent t test was used. To compare between groups for categorical data chi-square and Fisher exact test calculator was used.

Results: The study was carried out in total of 104 patients, out of which 52 patients received TA and 52 patients received placebo. In the study there was a decrease in mean duration of surgery, decreased blood loss during surgery, decreased reduction of hemoglobin and hematocrit in study group when compared with control group, which was statistically significant.

Conclusions: The present study concluded that TA significantly reduced perioperative blood loss and transfusion requirements during orthognathic surgery.

Keywords: Tranexamic acid - TA, AMCA -Amino Caproic Acid, EACA  - Epsilon- amino caproic acid, Hb- Hemoglobin, Hct     - Hematocrit.