Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Effect of tranexamic acid on blood loss reduction in patients undergoing orthognathic surgery under hypotensive anesthesia: a single-center, retrospective, observational study

  • Keisuke Harada (Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine) ;
  • Noritaka Imamachi (Department of Anesthesiology, Saitama Medical University) ;
  • Yuhei Matsuda (Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine) ;
  • Masato Hirabayashi (Department of Anesthesiology, Shimane University Faculty of Medicine) ;
  • Yoji Saito (Department of Anesthesiology, Shimane University Faculty of Medicine) ;
  • Takahiro Kanno (Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine)
  • Received : 2024.01.19
  • Accepted : 2024.04.24
  • Published : 2024.04.30
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Abstract

Objectives: Orthognathic surgery is a surgical procedure performed by intraoral approach with established and safe techniques; however, excessive blood loss has been reported in rare cases. In response, investigative efforts to identify methods to reduce the amount of blood loss have been made. Among such methods, the administration of tranexamic acid was reported to reduce the amount of intraoperative blood loss. However, few studies to date have reported the effect of tranexamic acid in orthognathic surgery under hypotensive anesthesia. The present study aimed to investigate the effect of the administration of tranexamic acid on intraoperative blood loss in patients undergoing bimaxillary (maxillary and mandibular) orthognathic surgery under hypotensive anesthesia. Patients and Methods: A total of 156 patients (mean age, 27.0±10.8 years) who underwent bimaxillary orthognathic surgery under hypotensive anesthesia performed by the same surgeon between June 2013 and February 2022 were included in this study. The following data were collected from the medical records of each patient: background factors (age, sex, and body mass index), use of tranexamic acid, surgical procedures, previous medical history, duration of surgery, American Society of Anesthesiology physical status findings before surgery, intraoperative blood loss as a primary outcome, in-out balance, and blood test results. Descriptive statistics were calculated for statistical analysis, and a t-test and the chi-squared test were used for between-group comparisons. Group comparisons were performed after 1:1 propensity score matching to adjust for confounding factors. Statistical significance was set at P<0.05. Results: Comparison between the groups based on the use of tranexamic acid revealed a significant difference in operation time. Propensity score matching analysis revealed that intraoperative blood loss was significantly lower in the tranexamic acid group. Conclusion: The administration of tranexamic acid was effective in reducing intraoperative blood loss in patients undergoing bimaxillary orthognathic surgery under hypotensive anesthesia.

Keywords

Acknowledgement

We would like to express our appreciation to the staff members of the Department of Oral and Maxillofacial Surgery and the Department of Anesthesiology of the Shimane University Faculty of Medicine.

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