The effect of different dosage regimens of tranexamic acid on blood loss in bimaxillary osteotomy: a randomized, double-blind, placebo-controlled study

Int J Oral Maxillofac Surg. 2018 May;47(5):608-612. doi: 10.1016/j.ijom.2017.10.007. Epub 2017 Nov 7.


The purpose of this study was to compare the effects of three dosage regimens of intravenous tranexamic acid and normal saline placebo on blood loss and the requirement for transfusion during bimaxillary osteotomy. A prospective, randomized, double-blind, placebo-controlled study was performed. Eighty patients scheduled for elective bimaxillary osteotomy were divided into four groups: a placebo group and three groups receiving a single dose of tranexamic acid 10, 15, or 20mg/kg body weight after the induction of anaesthesia. Demographic data, the anaesthetic time, the operative time, and the experience of the surgical team were similar in the four groups. Patients receiving placebo had increased blood loss compared to those receiving tranexamic acid. No significant difference in blood loss was found among those who received 10, 15, or 20mg/kg body weight of tranexamic acid. There was no significant difference in transfusion requirement, amount of 24-h postoperative vacuum drainage, length of hospital stay, or complications among the four groups. Prophylactic tranexamic acid decreased bleeding during bimaxillary osteotomy. Of the three dosages of tranexamic acid studied, the most efficacious and cost-effective dose to reduce bleeding was 10mg/kg body weight.

Keywords: blood loss in bimaxillary surgery; orthognathic surgery; tranexamic acid.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Antifibrinolytic Agents / administration & dosage*
  • Blood Component Transfusion / statistics & numerical data
  • Blood Loss, Surgical / prevention & control*
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Maxilla / surgery*
  • Operative Time
  • Osteotomy
  • Tranexamic Acid / administration & dosage*
  • Treatment Outcome


  • Antifibrinolytic Agents
  • Tranexamic Acid