{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T18:11:01Z","timestamp":1772561461485,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T00:00:00Z","timestamp":1675641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Postoperative epistaxis is a known possibility following endoscopic sinonasal surgery. Tranexamic acid (TXA) has been shown to reduce intraoperative blood loss and improve the visual field. This study evaluated the clinical efficacy of TXA when given at end of surgery to reduce postoperative bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This randomized, double\u2010blinded placebo\u2010controlled trial was conducted from April to November 2021. Patients scheduled to undergo endoscopic sinus or nasal surgery were randomized to receive an intravenous dose of 1\u00a0g TXA or saline intraoperatively prior to extubation. A 10\u2010in. visual analog scale (VAS) was used to query patients regarding postoperative bleeding each day for 1 week. The medical record was examined to determine the need for additional evaluations or interventions for epistaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty patients completed the study. The mean\u00a0\u00b1\u00a0SD postoperative bleeding VAS for the TXA group on the day of surgery was not significantly different from the saline group (4.82\u00a0\u00b1\u00a02.18 in. vs. 5.03\u00a0\u00b1\u00a02.14 in., <jats:italic>p<\/jats:italic>\u00a0=\u00a00.8). There were no significant differences between treatment arms on any postoperative day through day 7 (0.67\u00a0\u00b1\u00a01.84 in. vs. 0.87\u00a0\u00b1\u00a00.99 in., <jats:italic>p<\/jats:italic>\u00a0=\u00a00.7), nor in the reduction in VAS compared to the respective baseline on the day of surgery. There were no significant differences in terms of additional interventions (e.g., additional evaluation in recovery, ED, or clinic, need for packing, or return to the operating room [OR]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although TXA has previously demonstrated efficacy to reduce intraoperative bleeding during sinonasal surgery, when postoperative bleeding is already minimal at baseline, TXA does not appear to reduce it significantly further.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.23127","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T22:54:20Z","timestamp":1673045660000},"page":"1584-1591","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Tranexamic acid does not significantly lower postoperative bleeding after endoscopic sinus and nasal surgery"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9960-7758","authenticated-orcid":false,"given":"Ashoke","family":"Khanwalkar","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery University of Colorado Anschutz School of Medicine  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Stanford University School of Medicine  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pooya","family":"Roozdar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Stanford University School of Medicine  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dayoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Stanford University School of Medicine  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifei","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Stanford University School of Medicine  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter H.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Stanford University School of Medicine  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4454-0861","authenticated-orcid":false,"given":"Jayakar V.","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Stanford University School of Medicine  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2072-982X","authenticated-orcid":false,"given":"Zara M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Stanford University School of Medicine  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20777"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010018\u20104990\u20108"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-015-3863-7"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-014-3107-2"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.0884"},{"issue":"7858","key":"e_1_2_7_7_1","first-page":"1","article-title":"Effect of 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