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Background <p>Endoscopic sinus surgery (ESS) success relies on optimal visualization, which can be impaired by intraoperative bleeding. Tranexamic acid (TXA) and dexmedetomidine are commonly used to minimize bleeding, yet their comparative efficacy in ESS remains unclear. This study aims to compare the effects of dexmedetomidine and TXA on intraoperative bleeding volume and surgical field quality during ESS.</p> Results <p>Intraoperative bleeding volume was substantially lower in dexmedetomidine group at 15, 30, 60, and 90&#xa0;min (<i>p</i> &lt; 0.001), with an overall reduction of 70.86 ± 3.82&#xa0;mL versus 82.18 ± 4.71&#xa0;mL in the TXA group (<i>p</i> &lt; 0.001). Surgical field quality was substantially better in dexmedetomidine group across all time points (<i>p</i> &lt; 0.001). Multivariate regression identified dexmedetomidine as the only significant predictor of reduced bleeding volume (<i>B</i> = − 11.249, <i>p</i> &lt; 0.001) and improved surgical field quality (<i>B</i> = − 0.815, <i>p</i> &lt; 0.001).</p> Conclusion <p>Dexmedetomidine significantly reduces intraoperative bleeding and improves surgical field quality compared to TXA during ESS, supporting its use as an effective alternative for enhanced surgical outcomes.</p>

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The Effect of Tranexamic Acid Versus Dexmedetomidine on Bleeding in Endoscopic Nasal Surgery

  • 期刊论文

  • 发表日期：

    2025年8月18日

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  • Rami Fatouh Tantawy,
  • Ahmed Mostafa Ibrahim Abosakaya,
  • Yasser Mandour,
  • Ahmed Mohamed Elrefai

摘要

Background

Endoscopic sinus surgery (ESS) success relies on optimal visualization, which can be impaired by intraoperative bleeding. Tranexamic acid (TXA) and dexmedetomidine are commonly used to minimize bleeding, yet their comparative efficacy in ESS remains unclear. This study aims to compare the effects of dexmedetomidine and TXA on intraoperative bleeding volume and surgical field quality during ESS.

Results

Intraoperative bleeding volume was substantially lower in dexmedetomidine group at 15, 30, 60, and 90 min (p < 0.001), with an overall reduction of 70.86 ± 3.82 mL versus 82.18 ± 4.71 mL in the TXA group (p < 0.001). Surgical field quality was substantially better in dexmedetomidine group across all time points (p < 0.001). Multivariate regression identified dexmedetomidine as the only significant predictor of reduced bleeding volume (B = − 11.249, p < 0.001) and improved surgical field quality (B = − 0.815, p < 0.001).

Conclusion

Dexmedetomidine significantly reduces intraoperative bleeding and improves surgical field quality compared to TXA during ESS, supporting its use as an effective alternative for enhanced surgical outcomes.