الفهرس 
Introduction
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Abstract
Tranexamic acid is in the antifibrinolytic family of medications. It is a medication used to treat or prevent excessive blood loss from major trauma, post- partum bleeding, surgery, tooth removal, nose bleeds, and heavy menstruation. This study was conducted to assess the effect of TXA topically and systemically on bleeding and quality of surgical field during ear exploration surgery and the potential side effects.
Methods
Ninety patients undergoing ear exploration surgery were randomly divided into three group.
group A 30 patients received systemic TXA in a dose of 10 mg I.V over 30 min. followed by infusion in a dose of 1 mg / kg /hr throughout the duration of surgery.
group B 30 patients received topical TXA in a dilution of 1 gm diluted in 200 ml saline for surgical wash and soaking the used gauze for compression on the bleeding site.
group C 30 patients received diluted adrenaline 1 mg diluted on 200 ml saline used for surgical wash and soaking gauze used for compression of the bleeding site and this considered as control group..
Assessment parameters included; Demographic data (age, gender, height and weight), clinical data (Heart rate, Mean arterial blood pressure, end tidal CO2 and Arterial oxygen saturation), anesthesia time, operation time, recovery time, the quality of the surgical field using Boezaart grading with 0-5 scores, amount of bleeding during surgery and postoperative nausea, vomiting and blurring of vision.
Results
There were no significant differences between groups in the demographic and clinical characteristics regarding age, sex, weight, height and in anesthesia time, surgical time or time of recovery.
The quality of surgical field was better in group B than group A than group C, the intraoperative bleeding was significantly reduced in group B than group A than group C and the postoperative nausea, vomiting and blurring of vision were more in group A than the other groups.
conclusion
This study demonstrated the superiority of topical TXA in reducing bleeding and improving the quality of surgical field during ear exploration surgery with no significant side effects and we recommend the use of topical TXA to improve the quality of surgical field during ear exploration surgery.