The Effect of Different Dose Regimens of Tranexamic Acid in Reducing Blood Loss in Rhinoplasty: A Prospective Randomized Controlled Study

Rhinoplasty is a common surgical procedure. Bleeding prevention is a crucial part of the surgery. We aimed to evaluate the different dose regimens of tranexamic acid (TXA) in reducing intraoperative blood loss among patients undergoing rhinoplasty.This prospective randomized study was performed in patients scheduled for rhinoplasty surgery between March 2019 and March 2020. The patients were divided into 3 groups containing 30 patients in each group. The patients in Group 1 received the first dose of 1 g intravenous (IV) TXA 10 minutes before the surgery, and the second dose was administered at the end of the operation. The patients in Group 2 received only a single dose of 1 g of IV TXA 10 minutes before the surgery. The patients in Group 3 did not receive medication. Demographic data were obtained through a review of patient's medical records. Preoperative and postoperative hemoglobin levels, postoperative transfusion, and complications rate were compared between the study groups.No significant differences were observed between the study groups in terms of age, gender, body mass index, American Society of Anesthesiologists scores, and the level of preoperative Hb values (P > 0.05). The mean total blood loss was lower in Group 1 than the other groups, but the difference was not statistically significant (P = 0.464).The administration of single-dose IV TXA or intermittent IV doses of TXA could decrease total blood loss in rhinoplasty, but the statistical and clinical relevance was not significant.