Use of Nebulized Tranexamic Acid to Reduce Epistaxis during Awake Nasotracheal Intubation: A Case Report
Mohammed RABI ANDALOUSSI *
Department of Anesthesiology and Intensive Care, Military Teaching Hospital Mohammed V, Rabat, Morocco and Faculty of Medicine and Pharmacy of Casablanca, HASSAN II University of Casablanca, Morocco.
Rida TOUAB
Department of Anesthesiology and Intensive Care, Military Teaching Hospital Mohammed V, Rabat, Morocco.
Khalil MOUNIR
Department of Anesthesiology and Intensive Care, Military Teaching Hospital Mohammed V, Rabat, Morocco.
Abdelhamid JAAFARI
Department of Anesthesiology and Intensive Care, Military Teaching Hospital Mohammed V, Rabat, Morocco.
Hicham BALKHI
Department of Anesthesiology and Intensive Care, Military Teaching Hospital Mohammed V, Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Epistaxis is the most common complication of nasotracheal intubation (NTI). It may transform a difficult intubation into an impossible one. Several measures had been used to limit the NTI-related nosebleed but have never included the use of nebulized Tranexamic Acid (TXA).
We describe a patient who presented epistaxis during awake NTI. We tried to perform a nasal packing but the patient refused and became uncooperative. As an alternative, nebulized TXA was administered which allowed a successful control of the nosebleed. Our case report emphasizes that nebulized TXA, a non-invasive and patient-friendly option could be used as prophylactic measure or treatment to reduce nosebleed during awake NTI.
Keywords: Intubation, epistaxis, tranexamic acid, nasotracheal, nebulized