The aim of this study is to investigate the effect of preoperative administration of intravenous or nebulized tranexamic acid on surgical field, blood loss, anesthetic consumption and hemodynamics of patients undergoing FESS.
Primary outcome Modena Bleeding Score (MBS) assessing surgical field Secondary outcome
1. Patient hemodynamics. 2. Anesthetic consumption, Extra doses of fentanyl and propofol and sevoflurane\>2 3. Postoperative complications: including any adverse effects to TXA e.g.nausea, vomiting, any visual disturbances, fits, and any thrombotic manifestation.
Either sex
age 18-65 years
ASA I-II who are listed for elective functional endoscopic sinus surgery (FESS) under general anesthesia
normal accepted coagulation profile and hematocrit value ≥30
• chronic renal failure
liver cirrhosis
bleeding disorders
current anticoagulant therapy
Parallel
Tranexamic Acid (TXA)
DrugTo see if nebulised TXA is better to control blood loss in functional Endoscopic sinus surgery
Tranexamic Acid
DrugTo see if intravenous TXA is better to control blood loss in functional Endoscopic sinus surgery
Modena Bleeding Score- assessing surgical field
* No bleeding -\>1. * Bleeding easily controlled by suctioning, washing, or packing without any significant modification or slowing of surgical procedure-\>2. * Bleeding slowing surgical procedure-\>3. * Most of the maneuvers dedicated to bleeding control -\>4. * Bleeding that prevents every surgical procedure except those dedicated to bleeding control-\>5.
Measuring patient's Blood Pressure-> mmhg (unit of measure)
Measuring patient's Respiratory Rate-> breath per minute(unit of measure)
Measuring patient's Temperature-> Celsius(unit of measure)
Measuring patient's Pulse->Beat per minute(unit of measure)
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