Nitinol clips sternal osteosynthesis after heart/great arteries surgery as a method for prevention of postoperative complications

The problem of sternal osteosynthesis after cardiac surgery is relevant because of a relatively high incidence of postoperative complications associated with inadequate sternal consolidation. The use of nitinol clips is one of the reliable and versatile methods of sternal osteosynthesis. Our research included 208 postoperative patients with different cardiac surgical pathologies. All interventions were carried out with cardiopulmonary bypass using median sternotomy. Patients were divided into 2 groups according to sternal fixation methods: group 1 (105 patients) - wire suture osteosynthesis, group 2 (103 patients) - nitinol clips closure. The short-term postoperative results were analyzed by using the major criteria for comparison. Radiographically confirmed varying degrees of sternal defects in the immediate postoperative period were observed in 15.2% of patients in group 1 and 3.8% of patients in group 2. In group 1 significant sternal defects requiring sternal refixation were observed in 4.8% of patients; in group 2 no such cases were identified. The mean blood loss in the drainages for 24 hours after surgery in group 1 was 351 65 ml; in group 2 - 192 43 ml. The total number of resternotomies for bleeding in group 1 was 6.7% of cases, with half of them being the patients with the source from the sternum in the site of wire sutures, while in group 2 4.9% patients underwent resternotomy, with no bleeding from the sites of clip fixation. Thus, the use of nitinol clips after longitudinal median sternotomy is a more reliable method of sternal osteosynthesis (as compared with the classical method), which enables us to minimize the risk of damage to the retrosternal structures, preserve sternal consolidation and reduce blood loss in the drainages in the early postoperative period.

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Usage of 25% albumin solution in the intraoperative and early postoperative periods of liver transplantation from a cadaveric donor.

Тромбоз, гемостаз и реология ◽

10.25555/thr.2021.4.1000 ◽

2021 ◽

Author(s):

С.В. Журавель ◽

Н.К. Кузнецова ◽

В.Э. Александрова ◽

П.В. Гаврилов ◽

А.М. Талызин ◽

...

Keyword(s):

Liver Transplantation ◽

Postoperative Period ◽

Human Albumin ◽

Early Postoperative Period ◽

Hemodynamic Parameters ◽

Albumin Solution ◽

Transfusion Therapy ◽

Group 2 ◽

Human Albumin Solution ◽

Group 1

Введение. Терапевтическое использование раствора человеческого альбумина у пациентов в периоперационном периоде трансплантации печени (ТП) представляет интерес в контексте осложнений и исходов операции. Цель исследования: оценить влияние интраоперационной трансфузии 25% раствора человеческого альбумина на течение раннего послеоперационного периода при ортотопической ТП от посмертного донора. Материалы и методы. В исследование включены 47 пациентов, которым была выполнена трупная ТП. Были сформированы 2 группы: пациенты группы 1 (n = 21) получали трансфузию 25% раствора человеческого альбумина в конце операции ТП и через 24 ч после операции; пациенты группы 2 (n = 26) получали трансфузию 25% раствора человеческого альбумина в первые сутки послеоперационного периода. Осуществляли контроль лабораторных параметров крови пациента перед началом оперативного вмешательства, через 24 ч и через 48 ч после операции. Интраоперационно оценивали значения систолического (САД) и диастолического (ДАД) артериального давления, частоту сердечных сокращений (ЧСС), дозу вазопрессоров, объем инфузионно-трансфузионной терапии, кровопотерю и диурез. В послеоперационном периоде фиксировали возможные осложнения, проведенные сеансы заместительной почечной терапии (ЗПТ), а также количество дней в стационаре. Результаты. Оценка значений САД, ДАД и ЧСС в начале и конце операции показала достоверно лучшие показатели гемодинамики и снижение дозировок вазопрессорной поддержки в конце вмешательства в группе 1 по сравнению с группой 2 (p < 0,05). В послеоперационном периоде инфекционные осложнения зарегистрированы у одного пациента группы 1 и у трех пациентов группы 2. Проведение ЗПТ потребовалось двум пациентам из группы 2. Все пациенты обеих групп были выписаны из стационара, при этом число дней госпитализации в группе 2 было статистически значимо больше по сравнению с пациентами группы 1: 26,9 ± 3,9 против 17,2 ± 4,3 (p < 0,05). Заключение. Интраоперационная инфузия 25% раствора альбумина позволяет стабилизировать показатели гемодинамики в конце операции ТП, снизить потребность в кардиотонической поддержке и сократить время госпитализации у пациентов после ТП. Background. The therapeutic use of human albumin solution in patients in the perioperative period of liver transplantation (LT) is of interest in the context of complications and outcomes of surgery. Objectives: to assess the effect of intraoperative transfusion of 25% human albumin solution on the early postoperative period in orthotopic LT from a postmortem donor. Patients/Methods. The study included 47 patients who underwent cadaveric LT. Two groups were formed: patients in group 1 (n = 21) received transfusion of 25% human albumin solution at the end of LT and 24 hours after surgery; patients in group 2 (n = 26) received transfusion of 25% human albumin solution on the first day of the postoperative period. The laboratory parameters of the patient’s blood were monitored before surgery, 24 hours later, and 48 hours after surgery. Intraoperatively, the values of systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), dose of vasopressors, volume of infusion- transfusion therapy, blood loss and diuresis were assessed. In the postoperative period, possible complications, renal replacement therapy (RRT) sessions performed, and the number of days in the hospital were recorded. Results. Assessment of SBP, DBP and HR values showed significantly better hemodynamic parameters and reduced dosages of vasopressor support at the end of surgery in group 1 compared to group 2 (p < 0.05). In the postoperative period, infectious complications were registered in one patient of group 1 and in three patients of group 2. Two patients from group 2 required RRT. All patients were discharged from the hospital, while the number of hospitalization days in group 2 was statistically significantly greater than in patients in group 1: 26.9 ± 3.9 versus 17.2 ± 4.3 (p < 0.05). Conclusions. Intraoperative infusion of 25% albumin solution allows stabilizing hemodynamic parameters at the end of LT surgery, reducing the need for cardiotonic support and shortening the hospitalization time in patients after LT.

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Revisiting conventional adenoidectomy using technology

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202603 ◽

2020 ◽

Vol 6 (7) ◽

pp. 1232

Author(s):

Kiran Gangadhar S. ◽

Sonee Thingujam ◽

Jayita Poduval

Keyword(s):

Blood Loss ◽

Paediatric Population ◽

Lateral View ◽

Respiratory Pathogens ◽

Moderate Degree ◽

Ventilation Tubes ◽

The Mean ◽

Group 2 ◽

Mean Time ◽

Group 1

Background: Adenoidectomy is one of the most frequently applied surgical procedures in the paediatric population, either alone or in conjunction with tonsillectomy and/or insertion of ventilation tubes. The main purpose of the adenoidectomy is to eliminate the nasopharyngeal respiratory pathogens and to remove nasal airway obstruction. Aim of the study was to compare the outcomes of conventional and endoscopic assisted curettage adenoidectomy.Methods: In this comparative study, 50 patients were divided into 2 groups. Group 1 (25 patients) underwent endoscopic curettage adenoidectomy and group 2 (25 patients) underwent conventional curettage adenoidectomy. Intraoperative time, complications and postoperative pain were recorded. Results: 72% in group 1 and 64% in group 2 had grade 2 adenoid hypertrophy. 68% in group 1 and 64% in group 2 had a moderate degree of obstruction in lateral view of soft tissue X-ray nasopharynx. The mean time taken for surgery in group 1 was 13.29±3.28 minutes, and in group 2,6.28±2.31 minutes. Minimal loss of blood was recorded in group 1 with less than 20 ml, whereas in group 2, the blood loss was high; 30% of patients had blood loss more than 30 ml. In group 1, the mean VAS was 3.25 and 2.55 in group 2 2.55. In group 1, 4% of patients had primary haemorrhage and in group 2, 8% of patients had primary haemorrhage. No patient had velopharyngeal dysfunction in either group.Conclusions: More operative time but less blood loss were noted in endoscopic adenoidectomy. Intraoperative visualisation of the nasopharynx in endoscopic procedures showed no significant advantage over conventional adenoidectomy.

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Pathomorphology of adaptive changes in the remaining kidney in the early postoperative period after nephrectomy

Urologicheskie vedomosti ◽

10.17816/uroved10119-24 ◽

2020 ◽

Vol 10 (1) ◽

pp. 19-24

Author(s):

Igor Sergeevich Shormanov ◽

Marina S. Los ◽

Maxim V. Kosenko ◽

Natalia S. Shormanova

Keyword(s):

Postoperative Period ◽

Morphological Changes ◽

Renal Tissue ◽

Early Postoperative Period ◽

Left Group ◽

White Rats ◽

Group 3 ◽

Group 2 ◽

Single Kidney ◽

Group 1

Objective. To study the adaptive capacity of a single remaining kidney in the early postoperative period of nephrectomy in an experiment. Materials and methods. The experiment involved 35 laboratory white rats, which were divided into three experimental groups. Group 1 (n = 5) intact animals, group 2 (n = 15) animals underwent nephrectomy on the left; group 3 (n = 15) animals underwent nephrectomy and additionally were created 90 minute hypoxic hypoxia. Histological material was collected on the 5th, 21st and 60th days after surgery. Results. Characteristic morphological changes in the only remaining kidney were an increase in the size of the glomeruli and a decrease in their number. Nephron fibrosis was detected, accompanied by increased production of antigens by the tubular epithelium, which is likely a response to a cascade increase in oxidative stress and increased release of cytokines that stimulate the production of intrarenal collagen. Conclusion. Nephrectomy and hypoxia are provocateurs for the development of systemic distress syndrome, the result of which is the formation of a vicious pathogenetic circle, which reduces the functionality of the renal tissue. This can be considered as one of the early preclinical mechanisms for the initiation of single kidney disease in the future.

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Influence of residual blood autotransfused from cardiopulmonary bypass circuit on clinical outcome after cardiac surgery

Perfusion ◽

10.1191/0267659105pf792oa ◽

2005 ◽

Vol 20 (2) ◽

pp. 71-75 ◽

Cited By ~ 6

Author(s):

Edmundas Sirvinskas ◽

Tadas Lenkutis ◽

Laima Raliene ◽

Audrone Veikutiene ◽

Jolanta Vaskelyte ◽

...

Keyword(s):

Red Blood Cells ◽

Postoperative Period ◽

Blood Cells ◽

Heart Surgery ◽

Early Postoperative Period ◽

Group 3 ◽

Group 2 ◽

Residual Blood ◽

Infective Complications ◽

Group 1

Autotransfusion of the residual blood from the cardio-pulmonary bypass (CPB) circuit is considered to be one of the methods enabling reduction in the need for transfusion, the possible adverse effects of which are well known and documented. The aim of the study was to evaluate the effectiveness of the autologous autotrans-fusion of centrifuged red blood cells from the residual blood of the CPB circuit in patients following heart surgery. Three groups of patients who underwent heart surgery were examined. The first group (Group 1) consisted of 37 patients who received all of the residual blood in the bypass circuit after CPB (collected into sterile plastic bags) during the early postoperative period. The second group (Group 2) consisted of 45 patients who did not receive the residual blood following CPB. The third group (Group 3) consisted of 42 patients who underwent re-infusion of centrifuged red blood cells from the residual blood remaining in the CPB circuit during the early postoperative period. Hematocrit (Hct) values 12 hours after the operation were found to be higher in Group 3 compared with those of the first and the second groups (by 13.2% and 11.1%, respectively). Blood loss during the first 12 hours after the operation and during the time spent in the intensive care unit did not differ between the groups. The number of transfusions was significantly lower in Group 3 (28.57%) in comparison with that of Groups 1 and 2 (37.83% and 38.10%, respectively). The rate of infective complications in Group 3 was lower in comparison with both Group 1 and Group 2 (9.2% and 18.1%, respectively). The duration of in-hospital stay in Group 3 was 25.8% shorter than Group 1. We conclude that autotransfusion of centrifuged red blood cells processed from the residual blood of the CPB circuit after CPB was effective in increasing Hct values 12 hours postoperatively, reducing the need for donor blood product transfusions, the rate of infective complications and lenght of stay in hospital.

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Double versus single suture stenting to manage hypertensive spikes after glaucoma drainage device implantation

European Journal of Ophthalmology ◽

10.1177/11206721211014386 ◽

2021 ◽

pp. 112067212110143

Author(s):

Francesca Chemello ◽

Anna Rodella ◽

Guido Barosco ◽

Piero Ceruti ◽

Roberto Tosi ◽

...

Keyword(s):

Anterior Chamber ◽

Early Postoperative Period ◽

Glaucoma Drainage Device ◽

Drainage Device ◽

Device Implantation ◽

Baerveldt Glaucoma Implant ◽

The Mean ◽

Group 2 ◽

Single Suture ◽

Group 1

Purpose: To evaluate the safety and efficacy of double compared to single intraluminal suture stenting in reducing early postoperative hypertensive spikes (HS) and hypotony after Baerveldt glaucoma implant surgery. Methods: For this retrospective study, we reviewed the medical charts of 60 patients (60 eyes) who underwent Baerveldt drainage device surgery between 2017 and 2019. Two groups were formed according to whether a single suture stent was placed within the tube (5-0 polypropylene, 30 eyes, group 1) or a double suture (5-0 and 6-0 polypropylene, 30 eyes, group 2). Intraocular pressure (IOP) was measured at baseline, at 6 h, and on postoperative days 1, 2, 5, 7, 14, 21, 30, 60, 90, 180. The occurrence of HS (IOP ⩾ 30 mmHg), anterior chamber reformation, decompressive paracentesis, anti-glaucoma medication, and adverse events were recorded. Results: There was a greater decrease in IOP from baseline at days 1, 2, and 21 ( p < 0.05) and number of HS at 6 h ( p = 0.006) and postoperative day 1 ( p < 0.001) in group 2. The mean number of decompressive paracentesis, anterior chamber reformation procedures, and topical anti-glaucoma medications was the same in both groups; the need for oral acetazolamide was significantly lower in group 2 at days 1, 21, and 30 ( p < 0.05). Conclusions: While both stenting methods provide a gradual, controlled decrease in IOP, the double stenting technique was associated with a sooner and greater postoperative reduction in IOP and a good safety profile thanks to fewer HS in the early postoperative period and less need for oral acetazolamide.

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Comparison of Different IOL Types in the Flanged IOL Fixation Technique

Journal of Ophthalmology ◽

10.1155/2020/8534028 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Yusaku Miura ◽

Yosuke Harada ◽

Yoshiaki Kiuchi

Keyword(s):

Postoperative Complications ◽

Case Series ◽

Operation Time ◽

University Hospital ◽

Fixation Technique ◽

The Mean ◽

Group 2 ◽

Iol Fixation ◽

Group 1

Purpose. To compare short-term clinical outcomes between two different intraocular lens (IOL) types in the flanged IOL fixation technique. Methods. This study was a retrospective case series and included the patients who underwent flanged IOL fixation between June 2017 and July 2018 at the Hiroshima University Hospital. Two different 3-piece IOLs (NX-70 and PN6A) were used. Recipients of NX-70 and PN6A IOLs were classed into groups 1 (15 eyes) and 2 (25 eyes), respectively. Patient characteristics, surgical results, and postoperative complications were analyzed. We excluded patients with a postoperative follow-up of <1 month. Results. The mean follow-up period was 13.3 ± 11.7 weeks. The postoperative best corrected visual acuity, in logarithm of the minimum angle of resolution (logMAR), was 0.10 ± 0.33 in group 1 and 0.26 ± 0.42 in group 2. The mean operation times for groups 1 and 2 were 11.2 ± 4.54 minutes and 7.00 ± 2.20 minutes, respectively (p=0.0024). Detachment of the IOL haptic from the optic during surgery occurred in four eyes in group 2 (16%), but did not occur in group 1. Iris capture of the optic was observed in 3 of the 13 eyes (23%) without a peripheral iridotomy in group 2. No peripheral iridotomies were performed on group-1 eyes, but iris capture did not occur in that group. Conclusions. There was a trend to fewer intraoperative and postoperative complications when using NX-70 IOLs. On the other hand, PN6A IOLs was easy to maneuver within the anterior chamber, and the operation time was shorter when using PN6A IOLs. Selection of optimal IOLs for flanged IOL fixation necessitates an understanding of their characteristics in terms of intraoperative and postoperative complications.

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Same-stage nasal and palatopharyngeal surgery for obstructive sleep apnea: Is it safe?

Otolaryngology ◽

10.1067/mhn.2002.124186 ◽

2002 ◽

Vol 126 (4) ◽

pp. 399-403 ◽

Cited By ~ 17

Author(s):

Nicolas Y. Busaba

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Postoperative Period ◽

Arterial Oxygen Saturation ◽

Arterial Oxygen ◽

Obstructive Sleep ◽

The Mean ◽

Group 2 ◽

Continuous Pulse ◽

Group 1

OBJECTIVE: The study goal was to determine the safety of performing same-stage nasal and palatopharyngeal surgery for the treatment of obstructive sleep apnea syndrome (OSAS). STUDY DESIGN AND SETTING: We conducted a retrospective review of 91 consecutive patients who underwent surgery for OSAS at tertiary care facilities. METHODS: Patients were divided into 2 groups: group 1 had same-stage nasal and palatopharyngeal surgery (n = 63), whereas group 2 had palatopharyngeal surgery at a stage separate from the nasal surgery (n = 28). Patient demographics, severity of OSAS, type of surgery, perioperative care, and postoperative complications were reviewed. RESULTS: There were 55 men and 8 women in group 1, with an average age of 48 years. Group 2 consisted of 20 men and 8 women, with an average age of 45 years. The mean respiratory disturbance index was 36.5 and 33.5 for group 1 and 2, respectively. The mean lowest arterial Oxygen saturation for group 1 was 82%, whereas that of group 2 was 81%. Patients in both groups were observed in a hospital setting for a minimum of 1 day. They were admitted to a room close to the nurse's station, with continuous pulse oximeter monitoring. There were 3 complications reported for group 1: pneumonia (1 patient, postoperative day 4), tonsil bleed (1 patient, postoperative day 6), and septal hematoma (1 patient). One patient in group 2 had a tonsil bleed (postoperative day 8). There were no incidents of airway compromise or cardiopulmonary events in the immediate postoperative period. CONCLUSION: Same-stage nasal and palatopharyngeal surgery for OSAS is safe. Patients could be monitored with continuous pulse oximetry and managed outside of an intensive care unit setting in the immediate postoperative period.

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Topical N-acetylcysteine Reduces Interleukin-1-alpha in Tear Fluid after Laser Subepithelial Keratectomy

European Journal of Ophthalmology ◽

10.1177/112067210901900406 ◽

2009 ◽

Vol 19 (4) ◽

pp. 554-559 ◽

Cited By ~ 1

Author(s):

Berrak Urgancioglu ◽

Kamil Bilgihan ◽

Doruk Engin ◽

Meltem Yalinay Cirak ◽

Ahmet Hondur ◽

...

Keyword(s):

Wound Healing ◽

Interleukin 1 ◽

Early Postoperative Period ◽

Tear Fluid ◽

Control Group ◽

Corneal Wound Healing ◽

Corneal Wound ◽

The Mean ◽

Group 2 ◽

Group 1

Purpose To evaluate the effect of topical N-acetylcysteine (NAC) on interleukin 1-alpha (IL-1α) levels in tear fluid after myopic laser subepithelial keratectomy (LASEK) and its possible role in modulating corneal wound healing. Methods Twenty-six eyes of 13 patients who underwent myopic LASEK were divided into 2 groups. Group 1 (n=10 eyes) was used as a control group. All patients received topical lomefloxacin and dexamethasone postoperatively. Additionally, patients in Group 2 received topical NAC for 1 month postoperatively. Tear fluid samples were collected with microcapillary tubes preoperatively, on the first and on the fifth postoperative day, and the release of IL-1α in tear fluid was calculated. Haze grading and confocal microscopic examination were performed at 1 and 3 months postoperatively. Results The mean IL-1-α release values were 0.285±0.159 pg/min in Group 1 and 0.235±0.142 pg/min in Group 2 preoperatively. In Group 1, the values were 0.243±0.155 pg/min on day 1 and 0.164±0.125 pg/min on day 5. In Group 2, the mean IL-1α release values were 0.220±0.200 pg/min on day 1 and 0.080±0.079 pg/min on day 5. The difference between the groups was significant only for day 5 (p<0.05). Mean corneal haze score and grey scale value in confocal microscopy were significantly higher (p<0.05) in Group 1 at 1 month. However, at 3 months there was no difference between groups (p>0.05). Conclusions NAC seems to have an additive effect to steroids in suppressing IL-1α levels in tear fluid and may be clinically advantageous in modulating corneal wound healing during the early postoperative period after LASEK.

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The feasibility of shockwave lithotripsy for treating solitary, lower calyceal stones over 1 cm in size

Canadian Urological Association Journal ◽

10.5489/cuaj.473 ◽

2013 ◽

Vol 7 (3-4) ◽

pp. E156-160 ◽

Cited By ~ 5

Author(s):

Tae Beom Kim ◽

Sang Cheol Lee ◽

Khae Hawn Kim ◽

Han Jung ◽

Sang Jin Yoon ◽

...

Keyword(s):

Postoperative Complications ◽

Clinical Data ◽

Renal Calculi ◽

Shockwave Lithotripsy ◽

Lower Pole ◽

Stone Size ◽

The Mean ◽

Group 2 ◽

Anatomical Parameters ◽

Group 1

Introduction: Recently, few studies were reported about the treatment of large, solitary, renal calculi between shockwave lithotripsy (SWL) and percutaneous nephrolithotomy (PNL). We assess the feasibility of SWL for managing solitary, lower calyceal stones over 1 cm by comparing the results of lower pole calculi treatment between patients that underwent SWL or PNL.Methods: We retrospectively reviewed clinical data for patients who had undergone PNL or SWL due to lower calyceal stones over 1 cm. Group 1 consisted of patients who underwent SWL to treat lower pole renal calculi from 2010 to 2011. Group 2 included patients who underwent PNL to manage lower pole renal calculi from 2008 to 2009. We compared patient age, gender, stone size, comorbidities, postoperative complications, additional interventions and anatomical parameters between the two groups.Results: A total of 55 patients were enrolled in this study. The mean ages (±SD) of groups 1 (n = 33) and 2 (n = 22) were 55.1 (±13.0) and 50.0 (±10.6) years (p = 0.133) and mean stone sizes were 1.6 (±0.7) and 1.9 (±0.8) cm (p = 0.135), respectively. There were no significant differences in gender distribution, comorbidities or stone laterality between the two groups. No significant differences in various parameters were observed between patients with stones 1 to 2 cm and ones with stones 2 cm or larger.Conclusions: Our results demonstrated that SWL is a safe, feasible treatment for solitary, lower calyceal stones over 1 cm.

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Efficacy of Intraoperative Administration of Topical Tranexamic Acid Solution on Blood Loss During Surgical Removal of Impacted Mandibular Third Molar

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/611 ◽

2021 ◽

Vol 10 (35) ◽

pp. 2989-2993

Author(s):

Subhashini Ramasubbu ◽

Shivangi Gaur ◽

Abdul Wahab PU ◽

Madhulaxmi Marimuthu

Keyword(s):

Blood Loss ◽

Tranexamic Acid ◽

Third Molar ◽

Surgical Removal ◽

Impacted Mandibular Third Molar ◽

Mandibular Third Molar ◽

Male Patients ◽

The Mean ◽

Group 2 ◽

Group 1

BACKGROUND Perioperative haemorrhage is an important concern during any surgical procedure. The purpose of this study was to assess the effect of tranexamic acid (TXA) irrigation on perioperative haemorrhage during the surgical removal of impacted mandibular third molar. METHODS In this double-blind, randomized controlled clinical trial, 120 participants who underwent surgical removal of horizontally impacted mandibular third molar were divided into 2 groups. The patients in the Group 1 received 0.9 % normal saline for irrigation during the procedure and the patients in the Group 2 received TXA irrigation with normal saline (1 mg / mL), age, gender, operation duration, amount of blood loss and visual assessment of surgical field were the variables that were studied. The use of TXA solution for irrigation was the predictive factor of the study. RESULTS Each group consisted of 60 patients. Group 1 consisted of 31 male patients (51.7 %) and 29 female patients (48.3 %) and group 2 consisted of 30 male patients (50 %) and 30 female patients (50 %). There was no difference in the distribution of the variables between the 2 groups, except for the duration of the operation. The mean operative time was 20.94 ± 0.61 minutes in group 1 and 26.17 ± 0.98 minutes in group 2 (P > .05) which was not statistically significant. The mean intraoperative blood loss was 44.47 ± 6.416 mL in group 1 and 84.73 ± 7.861 in group 2 (P < .05). The mean volume of irrigation was 100.08 ± 7.658 mL in group 1 and 140.33 ± 12.332 mL in group 2 (P < .05). CONCLUSIONS TXA is effective in reducing the risk of intraoperative blood loss in patients for whom substantial blood loss is anticipated. KEY WORDS Tranexamic Acid, TXA, Blood Loss, Third Molar Surgery, Impacted Tooth Removal.

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