The efficacy of tranexamic acid for orthognathic surgery: a meta-analysis of randomized controlled trials

The efficacy of tranexamic acid in orthognathic surgery remains controversial. We conducted a systematic review and meta-analysis to explore the influence of tranexamic acid on blood loss for orthognathic surgery. We performed a search of PubMed, Embase, Web of science, EBSCO, and Cochrane library databases through October 2017 for randomized controlled trials (RCTs) assessing the effects of tranexamic acid versus placebo on orthognathic surgery. Meta-analysis was performed using the random-effects model. Six RCTs were included in the meta-analysis. Overall, compared with placebo in orthognathic surgery, tranexamic acid administration results in significantly decreased blood loss [mean difference (MD) = -159.73; 95% confidence interval (CI) = -236.42 to -83.03; P < 0.0001], and higher postoperative haemoglobin (MD = 0.71; 95% CI = 0.11 to 1.31; P = 0.02), but has no remarkable impact on postoperative haematocrit (MD = 1.23; 95% CI = -1.22 to 3.69; P = 0.33) and operation time (MD = -2.35; 95% CI = -18.05 to 13.36; P = 0.77). In addition, patients with orthognathic surgery need decreased amounts of irrigant fluid (MD = -229.23; 95% CI = -399.63 to -58.83; P = 0.008) after using tranexamic acid. We concluded that tranexamic acid promotes the bleeding control in orthognathic surgery.