Acid Tranexamic Effectiveness in Reducing the Intraoperative Bleeding in Palatoplasty

Study Overview
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Brief Summary
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Randomized study evaluating the role of tranexamic acid in reducing intraoperative bleeding in palatoplasty.

Detailed Description
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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.

Official Title
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Acid Tranexamic Effectiveness in Reducing the Intraoperative Bleeding in Palatoplasty : Randomized Study

Conditions
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Cleft Palate, Hemorrhage

Intervention / Treatment
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* Drug: Tranexamic Acid
* Drug: Saline


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 6 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Placebo<br>Saline infusion: Group receiving saline as placebo during the surgical procedure | Drug: Saline<br>* Infusion of saline in the same rate used for the intervention group<br>* Other names: Control;|
| Experimental: Intervention<br>Tranexamic acid infusion: Group that received a Tranexamic acid bolus of 10mg / kg, followed by continuous infusion of 1 mg / kg / hr until the end of the procedure. | Drug: Tranexamic Acid<br>* 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<br>* Other names: Transamin;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| intraoperative bleeding | 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. | during surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of wound dehiscence | 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). | 5 days | 
| Oronasal fistulas | Presence of oronasal fistula type II, III or IV in pittsburgh classification verified on postoperative return at 1 month and photographic record. | 1 month | 
| incidence of significant bleeding complications | Incidence of bleeding requiring surgical intervention, blood transfusion or use of antifibrinolytic drugs in the postoperative period | During hospital stay, an expected average of 2 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cleft Palate, Hemorrhage, Palatoplasty