ABSTRACT
Tranexamic acid has been used to reduce bleeding and the subsequent need for blood transfusion in many surgeries. Because orthognathic surgery can be associated with significant bleeding, this study evaluated the efficacy of prophylactic intravenous [IV] tranexamic acid on blood loss during bimaxillary osteotomy. Thirty-two consecutive patients, scheduled for elective bimaxillary osteotomy, were included in the study and 16 were randomly assigned to each group. They received tranexamic acid [20 mg/kg] or equal volume of placebo [normal saline] intravenously just before induction of anesthesia. Intraoperative blood loss, pre and post operative hemoglobin [Hb] and hematocrit [Hct] concentration, duration of surgery, hospital stay time, and rate of blood transfusion were recorded for each patient. Intraoperative blood loss in the tranexamic group and control group were 585.9 and 790 mL respectively [P=0.008]. Postoperative Hb concentration at the 6[th] hour was greater in the tranexamic group [P=0.008]. There was no significant difference in the Hct concentration between the study groups. There was no significant difference in blood transfusion rate, hospital stay time and duration of surgery between the study groups. Preoperative IV administration of tranexamic acid reduces the amount of blood loss during bimaxillary osteotomy
ABSTRACT
Post operative vomiting [POV] is one of the most distressing complications after surgery especially in children. Since prophylactic treatment in all patients may be accompanied by many side effects, we conducted a study to evaluate the history of motion sickness [MS] as a risk factor and its predictive value for post operative vomiting in children. In a prospective ªohort study, a sample of 100 consecutive patients aged 1-16 years scheduled for elective surgery under general anesthesia were questioned, a history of MS was sought and patients were observed during next 24 hours for the subsequent development of POV. The overall incidence of POV was 30%. Twenty one patients were MS positive and 79 were negative. MS-positive children were more likely to vomit than those who were MS-negative [P=0.02]. Demographic data, type of surgery, technique of anesthesia, duration of fasting and surgery did not differ significantly between the two groups. The sensitivity of MS as a predictor of POV was 51% and the specificity 90%, giving a positive predictive value of 81% and negative predictive value 80%. Motion sickness is associated with POV in this group of children, and its positive predictive value is high