The purpose of the study is to compare the effect of oral tranexamic acid vs. intravenous in decreasing bleeding and improving the field during FESS.

The use of tranexamic acid during Intraoperative bleeding in functional endoscopic sinus surgery (FESS) improves the outcome. Bleeding is one of the most devastating complications during fess. Tranexamic acid is used in open heart surgery to improve the surgical field.

Using oral vs. intravenous forms of the drug will add to our knowledge and improve outcomes.

Inclusion Criteria:

• American Society of Anesthesiologists grade I or II.
• Sex: Both sexes.
• Age between 18 and 40 years.
• Patients scheduled for FESS under general anesthesia.

Exclusion Criteria:

• Declining to give written informed consent.
• History of allergy to the medications used in the study.
• History of venous or arterial thrombosis.
• history of cardiovascular diseases including AF, IHD, or hypertension.
• History of chest problems including pulmonary embolism, bronchial asthma and COPD.
• History of cerebrovascular stroke.
• History of drug or alcohol abuse.
• Taking opioids or sedative medications.
• Hepatic or renal failure.
• Bleeding disorders, antiplatelets (aspirin, clopidogrel) or anticoagulant (warfarin).