Tranexamic Acid (TXA) topically applied was compared to anterior nasal packing in 216 patients with acute anterior epistaxis. Cotton pledgets (15 cm) soaked in injectable TXA (500 mg/5 ml) were inserted into the bleeding nostril and removed after bleeding had arrested. This was compared to standard anterior packing.
RESULTS
TXA Anterior packing
% pts bleeding stopped in 10 min: 71% 31.2%
Discharge after 2 hours 95.3% 6.4%
Rebleeding in 24 h hours 4.7% 11%
Satisfaction scores 8.5 4.4
Bottom line: topical tranexamic acid looks promising for control of uncomplicated anterior epistaxis.
References
Zahed R, Moharamzadeh P, AlizadeArasi S, Ghasemi A, Saeedi M. A new and rapid method for epistaxis treatment using injectable form of tranexamic acid topically: a randomized controlled trial. AJEM 2013 (31):1389-92.
