• Anjan Das, Surajit Chattopadhyay, Debabrata Mandal, Subinay Chhaule, Tapobrata Mitra, Anindya Mukherjee, Subrata Kumar Mandal, and Sandip Chattopadhyay.
• Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Berhampore, West Bengal, India.
• Anesth Essays Res. 2015 Sep 1; 9 (3): 384-90.

BackgroundHead and neck cancer (HNC) surgery is associated with high intraoperative blood loss which may require urgent blood transfusion. Many strategies have been recommended to decrease the need for allogenic transfusion. Use of perioperative tranexamic acid (TA) has a promising role.AimsThis study was to evaluate the effectiveness of single preoperative bolus dose of TA on blood loss prevention and red blood cell transfusion in patients undergoing HNC surgery.Study DesignA prospective, double-blind, and randomized controlled study.Materials And MethodsFrom 2007 July to 2010 January; 80 patients, aged (35-55), of American Society of Anesthesiologists II-III scheduled for unilateral HNC surgeries were randomly received either TA (Group T) in a dose of 20 mg/kg diluted to 25 cc with normal saline or an equivalent volume of normal saline (Group C) in a tertiary care hospital. Hemoglobin (Hb) concentration, platelet count, packed cell volume, fibrinogen level, D-dimer level were measured pre- and post-operatively.ResultsSaline (C) Group required more blood, colloid, crystalloid for blood loss. In Group T, 32 patients did not require transfusion of any blood products compared to five patients in Group C (P < 0.0001) and only eight units of blood was transfused in Group T, whereas a total of 42 units of blood was transfused in Group C. Even after numerous transfusions, Hb% after 6 h and 24 h in Group C were significantly low in comparison with Group T (P < 0.05).ConclusionThus, TA significantly reduces blood loss and chances of colloid, blood, and crystalloid transfusion caused by HNC surgery.

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