Optimal Dose of Vasopressin in Laparoscopic Myomectomy for Fibroid Uterus
Tue - June 22, 2021
Guo Feihe,Jiao Cuicui,Xu Kaihong,Yang Chunbo,Huang Xiadi,Lu Yongchao,Xu Lili,XinZhong Chen
Dose of Vasopressin in Myomectomy
Uterine leiomyoma is the most common benign tumor in women of reproductive age with an incidence up to 70%~80%. About 20%~50% of women with uterine leiomyoma are symptomatic. Myomectomy is the standard treatment for women who wish to preserve their uterus for fertility. Surgery, however, may be associated with a risk of bleeding 4, which hampers surgical view, prolongs operating time, increase complications. Vasopressin is routinely injected into the myoma for vasoconstriction and hydro separation.
Objective: To determine the optimal effective dose of pituitrin in laparoscopic myomectomy for uterine leiomyoma. Design: Prospective, double-blinded, randomized controlled trial. Setting: A tertiary women’s hospital in China. Population: A total of 118 women underwent laparoscopic myomectomy. Methods: Women were randomly divided into four groups to receive 0, 2, 4, or 6 units of pituitrin in the leiomyoma (groups 0U, 2U, 4U, and 6U, respectively).
Main outcome measures: Rate of the satisfactory surgical field, hemodynamic changes, total surgical time, and blood loss were recorded. Results: The rate of the satisfactory surgical field was 6.7%, 72.4%, 89.7%, and 93.3% in groups 0U, 2U, 4U, and 6U, respectively; it was higher in groups 2U, 4U, and 6U than group 0U, but there were no significant differences among the groups 2U, 4U, and 6U. The blood loss was higher in group 0U than that in groups 2U, 4U, and 6U ().
Pituitrin was associated with a transient decrease in blood pressures and increase in heart rate in a dose-dependent fashion, with more pronounced changes in groups 4U and 6U and these groups also required a higher amount of vasoactive drug to correct hemodynamic changes (p<0.05).
Conclusions: The use of low-dose pituitrin (2 units) provides a satisfactory surgical field with minimal hemodynamic changes.