{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:36:37Z","timestamp":1790087797707,"version":"4.0.1"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"16","license":[{"start":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T00:00:00Z","timestamp":1716508800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T00:00:00Z","timestamp":1716508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004156","name":"Mahidol University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004156","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Aesth Plast Surg"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Eyelid surgery is one of the top five aesthetic procedures. It is performed to improve both appearance and function, but intraoperative bleeding leads to adverse events which perturb patients. The objective of this study was to demonstrate the efficacy of TXA combined with epinephrine in decreasing intraoperative blood loss and postoperative inflammation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This prospective randomized control trial was performed on the 30 eyelids of 15 patients who underwent upper blepharoplasty. One of each patient\u2019s eyes was randomly assigned to the TXA group, and the other eye was in the control group. Eyes in the TXA group were given 2% lidocaine with epinephrine (1:100000) mixed with TXA (50\u00a0mg\/ml) in 1:1 mixture subcutaneously as a local anesthetic. The eyes in the control group received 2% lidocaine with epinephrine (1:100000) diluted with normal saline in 1:1 mixture. Intraoperative blood loss and postoperative swelling were compared between the two groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Intraoperative blood loss was significantly higher in the TXA group [4.86 (1.83)\u00a0ml] than it was in the control group [2.53 (1.49)\u00a0ml] (<jats:italic>p\u2009<\/jats:italic>&lt;\u20090.001). There was no statistically significant difference between the two groups in operative time (<jats:italic>p\u2009<\/jats:italic>=\u20090.645), pain score (<jats:italic>p\u2009<\/jats:italic>=\u20090.498), lid crease (<jats:italic>p\u2009<\/jats:italic>=\u20090.548), or MRD1 (<jats:italic>p\u2009<\/jats:italic>=\u20090.626). On postoperative day 7, there was no difference in lid crease (<jats:italic>p\u2009<\/jats:italic>=\u20090.879), MRD1 (<jats:italic>p\u2009<\/jats:italic>=\u20090.463), pain score (<jats:italic>p\u2009<\/jats:italic>=\u20090.934), or ecchymosis (<jats:italic>p\u2009<\/jats:italic>=\u20090.976) between two groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>TXA in lidocaine with epinephrine was found to increase intraoperative bleeding compared to lidocaine with epinephrine alone, but there was no difference in postoperative swelling or ecchymosis. TXA combined with lidocaine and epinephrine injected subcutaneously should be avoided until additional relevant data are obtained. Further drug interaction study is needed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Level of Evidence II<\/jats:title>\n                <jats:p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.springer.com\/00266\">www.springer.com\/00266<\/jats:ext-link>.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00266-024-04112-z","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T17:02:08Z","timestamp":1716570128000},"page":"3076-3081","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Tranexamic Acid Subcutaneously Administered with Epinephrine and Lidocaine in Upper Blepharoplasty: A Randomized Double-Blind Control Trial"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0947-2759","authenticated-orcid":false,"given":"Thitinan","family":"Chaichumporn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puritat","family":"Kanokkangsadal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achariya","family":"Sarovath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,24]]},"reference":[{"key":"4112_CR1","first-page":"33","volume-title":"Plastic surgery","author":"F Julius Jr","year":"2018","unstructured":"Julius F Jr, Ellis M (2018) Blepharoplasty. In: Rubin JP (ed) Plastic surgery, vol 2. Elsevier, New York, p 33"},{"issue":"3","key":"4112_CR2","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1097\/PRS.0b013e3181ce17e8","volume":"125","author":"GJ Lelli Jr","year":"2010","unstructured":"Lelli GJ Jr, Lisman RD (2010) Blepharoplasty complications. Plast Reconstr Surg 125(3):1007\u20131017","journal-title":"Plast Reconstr Surg"},{"issue":"5","key":"4112_CR3","doi-asserted-by":"publisher","first-page":"585","DOI":"10.2165\/11209070-000000000-00000","volume":"72","author":"PL McCormack","year":"2012","unstructured":"McCormack PL (2012) Tranexamic acid: a review of its use in the treatment of hyperfibrinolysis. 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Crit Care 11:R117","journal-title":"Crit Care"},{"issue":"1","key":"4112_CR5","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1186\/1749-8090-6-138","volume":"6","author":"JJ Jim\u00e9nez","year":"2011","unstructured":"Jim\u00e9nez JJ, Iribarren JL, Brouard M, Hern\u00e1ndez D, Palmero S, Jim\u00e9nez A et al (2011) Safety and effectiveness of two treatment regimes with tranexamic acid to minimize inflammatory response in elective cardiopulmonary bypass patients: a randomized double-blind, dose-dependent, phase IV clinical trial. J Cardiothorac Surg 6(1):138","journal-title":"J Cardiothorac Surg"},{"issue":"2","key":"4112_CR6","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1056\/NEJMoa1606424","volume":"376","author":"PS Myles","year":"2017","unstructured":"Myles PS, Smith JA, Forbes A, Silbert B, Jayarajah M, Painter T et al (2017) Tranexamic acid in patients undergoing coronary-artery surgery. 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