{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T03:57:44Z","timestamp":1768708664320,"version":"3.49.0"},"reference-count":40,"publisher":"Brieflands","issue":"1","license":[{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["brieflands.com"],"crossmark-restriction":false},"short-container-title":["Anesth Pain Med"],"abstract":"<jats:p>Background: Open cranial vault reconstruction is the standard technique of craniosynostosis correction that may cause significant blood loss. Objectives: The current study aimed at comparing the effect of tranexamic acid (TXA), controlled hypotension, and their combination on perioperative blood loss and transfusion requirement in craniosynostosis surgery. Methods: The present randomized, double-blind clinical trial was conducted on 75 infants referred for craniosynostosis surgery during 2017 - 2018. Ten minutes before the start of surgery, 10 mg\/kg of TXA was administered intravenously to patients in the first group (TXA group). In the second group, patients were subjected to the controlled hypotension anesthesia (CHA) using intravenous remifentanil 0.1 \u03bc\/kg (CHA group). In the third group, the patients underwent CHA similar to that of the second group, along with intravenous injection of 10 mg\/kg of TXA (CHA-TXA group). Then, patients\u2019 mean arterial pressure (MAP), heart rate (HR), total blood loss, and transfusion volume were evaluated and recorded. Results: The results of the present study revealed that although the changes in MAP and HR parameters over time (three hours after surgery) were significant in all three groups, the lowest decrease was observed in the CHA-TXA group (P-value &lt; 0.05). In addition, the total perioperative blood loss in the CHA-TXA group with the mean of 181.20 \u00b1 82.71 cc was significantly less than the total perioperative blood loss in the CHA and TXA groups with the means of 262.00 \u00b1 104.04 cc and 212.80 \u00b1 80.75 cc, respectively (P-value &lt; 0.05). Moreover, the transfusion volume in the CHA-TXA group with the mean of 112.40 \u00b1 53.50 cc was significantly lower than the transfusion volume in the CHA and TXA groups with the means of 174.00 \u00b1 73.93 cc and 160.63 \u00b1 59.35 cc, respectively (P-value &lt; 0.05). In contrast, the total blood loss and transfusion volume were not significantly different between the CHA and TXA groups (P-value &gt; 0.05). Conclusions: According to the results of the present study, although the administration of TXA alone could effectively prevent blood loss and was associated with fewer transfusion requirements, the combination of this approach with hypotensive anesthesia resulted in more reduction in perioperative blood loss and transfusion volume as well as better hemodynamic stability.<\/jats:p>","DOI":"10.5812\/aapm-130462","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T10:16:28Z","timestamp":1673864188000},"update-policy":"https:\/\/doi.org\/10.5812\/crossmark_update_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Effect of Tranexamic Acid and Controlled Hypotension on Perioperative Blood Loss in Craniosynostosis Surgery"],"prefix":"10.5812","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2192-1610","authenticated-orcid":false,"given":"Darioush","family":"Moradi 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