The outcomes of a randomized study issued in Journal of the Sciences and Specialties of the Head and Neck culminated that the combination of tranexamic acid (TA) in topical and intravenous (IV) formulations was the most useful in providing surgical field in functional endoscopic sinus surgery (FESS).

Hala Salah El‐Din El‐Ozairy and colleagues aimed to assess the local, IV and combined usage of TA for the improvement of surgical field quality throughout FESS.

One hundred and twenty patients scheduled for elective FESS were randomly designated to four groups after initiation of anesthesia- IV TA; local TA; combination of IV and local TA; and placebo. The five‐point Boezaart scale was used to examine the surgical field. Time of the surgery, recovery phase, after surgery issues, the use of fentanyl and esmolol were all noted.

Out of the four groups, the IV and local TA group displayed significant outcomes for surgical field quality score. These two groups also revealed significantly shorter mean operative time and recovery time along with lower fentanyl use. Mean arterial pressure and heart rate waning, variation of hematological determinations were found insignificant in all 4 groups.