Abstract
Objective
Epistaxis is a common problem in the emergency department (ED). Sixty percent of people
experience it at least once in their life. There are different kinds of treatment
for epistaxis. This study intended to evaluate the topical use of injectable form
of tranexamic acid vs anterior nasal packing with pledgets coated with tetracycline
ointment.
Methods
Topical application of injectable form of tranexamic acid (500 mg in 5 mL) was compared
with anterior nasal packing in 216 patients with anterior epistaxis presented to an
ED in a randomized clinical trial. The time needed to arrest initial bleeding, hours
needed to stay in hospital, and any rebleeding during 24 hours and 1 week later were
recorded, and finally, the patient satisfaction was rated by a 0-10 scale.
Results
Within 10 minutes of treatment, bleedings were arrested in 71% of the patients in
the tranexamic acid group, compared with 31.2% in the anterior nasal packing group
(odds ratio, 2.28; 95% confidence interval, 1.68-3.09; P < .001). In addition, 95.3% in the tranexamic acid group were discharged in 2 hours
or less vs 6.4% in the anterior nasal packing group (P < .001). Rebleeding was reported in 4.7% and 11% of patients during first 24 hours
in the tranexamic acid and the anterior nasal packing groups, respectively (P = .128). Satisfaction rate was higher in the tranexamic acid compared with the anterior
nasal packing group (8.5 ± 1.7 vs 4.4 ± 1.8, P < .001).
Conclusions
Topical application of injectable form of tranexamic acid was better than anterior
nasal packing in the initial treatment of idiopathic anterior epistaxis.
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Article Info
Publication History
Published online: August 01, 2013
Accepted:
June 26,
2013
Received in revised form:
June 25,
2013
Received:
May 19,
2013
Footnotes
☆The authors declare that there is no conflict of interest with this manuscript.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
