Cleft Palate, Hemorrhage
Conditions
Keywords
Cleft Palate, Hemorrhage, Palatoplasty
Brief summary
Randomized study evaluating the role of tranexamic acid in reducing intraoperative bleeding in palatoplasty.
Detailed description
Double-blind randomized study comparing intraoperative bleeding in palatoplasty between patients who received tranexamic acid at a dose of 10mg / kg bolus followed by continuous infusion of 1 mg / kg / h until the end of the procedure and patients receiving placebo in similar arrangements. Besides the impact on the volume of intraoperative bleeding the incidence of postoperative wound dehiscence in the first week and the incidence of oronasal fistulas after 1 month were evaluated.
Interventions
DRUGTranexamic Acid
Tranexamic acid bolus of 10 mg / kg at the beginning of palatoplasty, followed by infusion of 1 mg / kg / h until the end of the procedure
DRUGSaline
Infusion of saline in the same rate used for the intervention group
Sponsors
Professor Fernando Figueira Integral Medicine Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Age
6 Months to No maximum
Healthy volunteers
No
Inclusion criteria
* Palatoplasty indication in patients of any age with presence of congenital cleft palate (with or without associated cleft lip), in the study hospital
Exclusion criteria
* Preoperative hemoglobin lower than 10 mg / dl or platelet count less than 100,000 / mm3 ; * Presence of coagulopathy caused by known coagulation cascade disorders or systemic diseases, or excessive bleeding history on previous occasions; * History of bleeding disorders in first-degree relatives; * Use of medications that may interfere with the coagulation cascade (platelet inhibitors or anticoagulants); * Indication of secondary palatoplasty with the purpose of correction oro-nasal fistula; * Known allergy to tranexamic acid.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| intraoperative bleeding | during surgery | Intraoperative bleeding volume defined as the sum of the volume of aspirated blood during the procedure and the volume of blood retained in the used gauze. The volume retained in the gauze was estimated by the difference between the dry weight and the weight after using them. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of wound dehiscence | 5 days | Presence of dehiscence of the surgical wound in partial or total plan of any extension, verified by clinical examination in the first postoperative return and photographic record. The existence of dehiscence was observed by the break in the suture line or extensive presence of fibrin in the wound bed (indicating open area at its base). |
| Oronasal fistulas | 1 month | Presence of oronasal fistula type II, III or IV in pittsburgh classification verified on postoperative return at 1 month and photographic record. |
| incidence of significant bleeding complications | During hospital stay, an expected average of 2 days | Incidence of bleeding requiring surgical intervention, blood transfusion or use of antifibrinolytic drugs in the postoperative period |
Outcome results
None listed