A Comparative Study on The Effects of Tranexamic Acid and Controlled Hypotension with Remifentanil on Blood Loss During Cleft Palate Repair

Background: Tranexamic acid competitively inhibits the activation of plasminogen and is thus effective in reducing blood loss during surgery. This study aimed to compare the effects of tranexamic acid and hypotension with remifentanil on blood loss during cleft palate repair. Methods: This clinical trial study recruited 74 patients in Imam Hossein Hospital, Isfahan, Iran, during 2016-17. Children under three years of age who were candidates for cleft palate repair were randomly divided into two groups. The first group received an intravenous infusion of remifentanil (0.1 μg/kg/min) after the induction of anesthesia. In the second group, an intravenous injection of 10 mg/kg tranexamic acid was slowly administered. The amount of blood loss and postanesthesia care unit (PACU) stay duration were the main measured variables. Results: The mean blood loss was 76.44 ± 14.7 and 57.76 ± 14.16 ml in the remifentanil and tranexamic acid groups, respectively (P 0.001). The mean duration of PACU stay was 64.59 ± 5.5 and 46.35 ± 4.4 minutes in the mentioned groups, respectively (P 0.001). Conclusion: There were no significant differences between the two groups in terms of demographic and baseline characteristics. According to our findings, tranexamic acid was more effective than remifentanil in decreasing intraoperative blood loss and PACU stay.