Efficacy of Tranexamic Acid in Pediatric Craniofacial and Orthognathic Surgery: A Meta-Analysis

Craniofacial and orthognathic surgery are high risk procedures for surgical blood loss. Significant blood loss leads to increased rates of blood product transfusion which may be associated with increased morbidity to the patient. The use of anti-fibrinolytics such as tranexamic acid has become popular in these procedures. However, the evidence to support its use in pediatric craniofacial and orthognathic surgery is sparse. This review analyzes the current randomized control trials assessing the use of tranexamic acid in craniofacial and orthognathic surgery. The study reviewed published literature up until December 20th, 2020. Six trials were included in this analysis. Pooled data showed that patients who received tranexamic acid during craniofacial or orthognathic surgery have less blood loss compared to those in control groups (mean difference—5.47 ml/kg [CI -7.02-3.82], P value