Use of Nebulized Tranexamic Acid to Reduce Epistaxis during Awake Nasotracheal Intubation: A Case Report
Mohammed RABI ANDALOUSSI, Rida TOUAB, Khalil MOUNIR, Abdelhamid JAAFARI, Hicham Balkhi
Asian Journal of Case Reports in Medicine and Health · pp. 391–395 · Published 15 Nov 2025
10.9734/ajcrmh/2025/v8i1274Abstract
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.
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