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Introduction: Tonsillectomy is a common surgical procedure, frequently performed to address recurrent tonsillitis, obstructive sleep apnea, and other related conditions. Despite its routine nature, post-tonsillectomy bleeding remains a significant concern. This study explores the role of Tranexamic Acid (TXA) in the management of post-tonsillectomy bleeding.

Methods: A retrospective chart review was performed on pediatric patients at a tertiary care facility who presented with postoperative tonsillectomy hemorrhage from March 2023-June 2023. Demographic data, sex assigned at birth, comorbid conditions, medication administration, and patient specific outcomes were collected for analysis.

Results: 41 consecutive patients were included in this study. The mean age for this preliminary data collection was 7.86 ± 4.32 years. Of the 41 patients, 32 received nebulized TXA while 9 did not. Of the patients that received nebulized TXA, 9 patients (28.1%) returned to the OR for control of bleeding while 23 patients (71.9%) had resolution of bleeding without surgical management. Of the patients who did not receive TXA, 4 patients (44.4%) returned to the OR for control of bleeding.

Conclusions: In this preliminary study, the use of nebulized TXA appears to be associated with a lower rate of return to the operating room for control of post-tonsillectomy bleeding in pediatric patients. While the sample size is limited, these initial findings suggest a potential benefit of TXA administration in reducing the need for surgical re-operation following tonsillectomy. Further research is needed to support these observations and establish the optimal dosing and administration protocols for TXA in this context.

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The use of Tranexamic Acid for control of post-tonsillectomy hemorrhage in the pediatric population