Background: Myomas are commonly associated with heavy menstrual bleeding, and myomectomy is the preferred treatment for fibroids in women of reproductive age. Effective control of bleeding during surgery is crucial to ensure proper dissection and to minimize the need for blood transfusions and hysterectomies. This study aimed to evaluate the impact of a single preoperative dose of oral tranexamic acid (TXA) 1g on intraoperative blood loss during laparoscopic myomectomy.
Materials and Methods: This prospective, randomized, double-blinded study included 36 female patients undergoing laparoscopic myomectomy. Participants were randomly assigned into two equal groups (C and D) using the closed envelope technique for concealment. Group C received a placebo, while Group D received 1g of oral TXA two hours before surgery. Both groups followed a standard anesthesia protocol. Intraoperative blood loss, surgical drain loss, and postoperative hemoglobin changes were measured. The incidence of any adverse drug-related events was also recorded.
Results: Demographic characteristics and anesthesia times were comparable between the two groups. Preoperative and postoperative hemoglobin levels were similar. However, the change in hemoglobin was significantly lower in Group D compared to Group C (1.11 ± 0.83 vs. 1.83 ± 1.04, p = 0.028). The mean intraoperative blood loss was significantly lower in Group D (236.11 ± 90.69 mL vs. 400 ± 224.26 mL, p = 0.009), while intraoperative blood transfusion rates were comparable. Postoperative hemoglobin levels were similar between the two groups.
Conclusion: Administration of a single preoperative dose of oral TXA significantly reduces intraoperative blood loss during laparoscopic myomectomy without causing significant complications. Further studies with larger sample sizes are warranted to confirm these findings.
Keywords: Blood loss, Fibroids, Laparoscopic, Myomectomy, Tranexamic acid.
