Abstract

Objective

To evaluate the effect of pre-operative administration of tranexamic acid in preventing prolonged post-operative bleeding in day-case patients. Day-case admission is highly appropriate for dentoalveolar surgery but one of the problems is prolonged post-operative haemorrhage which at times may delay discharge or necessitate readmission to hospital. Tranexamic acid has traditionally been used to treat post-operative bleeding.

Design

A prospective double-blind randomised study

Setting

Eastman Dental Hospital, London.

Subjects and methods

Fifty-six patients were consecutively selected from healthy adult volunteers who were having third molar extraction in the day case unit of the Eastman Dental Hospital over a period of 22 weeks. Tranexamic acid (25 mg/kg) or normal saline was administered intravenously at induction by the anaesthetist and blood loss was measured intra- and post-operatively.

Results

A significant reduction (P = 0.023) in the post-operative blood loss was found in the tranexamic acid group. However, there was no significant difference in the intra-operative (P = 0.4) and the overall total blood loss (P = 0.21). No patient receiving tranexamic acid required readmission to control prolonged bleeding, or suffered any side effects from the drug.

Conclusion

This study has shown that one intravenous pre-operative dose of tranexamic acid is effective in preventing excessive post-operative bleeding in patients undergoing third molar extraction under a day case general anaesthetic and therefore facilitates safe discharge from hospital.

1. Department of Oral & Maxillofacial Surgery, Rambam Medical Center, Technion Faculty of Medicine, Haifa, Israel