NORMAL SALINE SOAKED EXPANDABLE POLYVINYL ALCOHOL NASAL PACK VERSUS TRANEXAMIC ACID SOAKED EXPANDABLE POLYVINYL ALCOHOL NASAL PACK IN A PATIENT WITH EPISTAXIS: A COMPARATIVE STUDY

Abstract

Objectives: The study aims to compare the time required to arrest bleeding in patient packed with expandable polyvinyl alcohol nasal pack with locally applied tranexamic acid or with normal saline.

Materials and methods: A prospective comparative study was conducted at Kathmandu Medical College, ENT-HNS Department for a period of 12 months(January 2017-December 2017). Among 158 patients, 79 patients were included in each group in the study. The findings regarding the time taken to arrest the bleeding and evidence of re-bleeding seen after removal of pack in each group were noted and tabulated.

Results: Average time required for arrest of bleeding was 3.86 minutes in tranexamic acid group and 4.35 minutes in normal saline group. 55% of the patients belong to blood group O. Total number of 121 patients had associated DNS in anterior rhinoscopy. Out of 24 patients experiencing re-bleeding, 15 were from the normal saline soaked group.

Conclusion: Injectable tranexamic acid applied locally helps to reduce the bleeding time and prevents the evidence of re-bleeding in patients with epistaxis. Other study with larger sample size and multi-centered study is required to establish the result.

Keywords: Deviated Nasal Septum, epistaxis, Expandable Polyvinyl Alcohol nasal pack, Nasal packing, Tranexamic acid