HOW MUCH VASOPREIN MAXIMUM I CAN INJECT ONE TIME IN MYOMECTOMY
| Discussion in 'All Categories' started by DR FARISOMAR - Sep 5th, 2023 9:18 am. | |
DR FARISOMAR
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HOW MUCH VASOPREIN MAXIMUM I CAN INJECT ONE TIME IN MYOMECTOMY |
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re: HOW MUCH VASOPREIN MAXIMUM I CAN INJECT ONE TIME IN MYOMECTOMY
by Dr B S Bhalla -
Nov 19th, 2025
12:03 pm
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Dr B S Bhalla
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What the literature says about dose & safety • In a pilot randomized trial during laparoscopic/robotic myomectomy, they used 20 units vasopressin diluted in 100 mL saline (i.e., 0.2 U/mL) as one of the concentrations.  • A caution-article states that the “recommended safe intramyometrial dose … is 4-6 U used at a concentration of 0.2 U/mL” to reduce cardiac complications.  • A review mentions examples like “25 units vasopressin diluted in 250 mL saline” injected for a fibroid of size around 5 cm.  ⸻ ⚠️ My practical surgical recommendation for you Given your advanced laparoscopic/robotic setup, here’s how you might standardise your approach safely: • Use a low concentration; e.g., 0.05-0.2 U/mL (as the trial showed safety issues start to increase at higher concentrations).  • Limit the total dose to approx 4-6 units in many cases, especially in patients with cardiovascular risk, as safety data suggests this is a safer maximum for routine use. • If you must go higher (because of large fibroid bulk or multiple fibroids), ensure anaesthesia monitoring, aspirate before injection (to avoid intravascular), inject slowly, and keep volume and concentration as low as feasible. • Always document: dilution used, total units, volume, site of injection, vitals before/after. ⸻ ???? Why this is important • Vasopressin causes powerful vasoconstriction, which helps reduce myometrial bleeding, but can also cause bradycardia, cardiovascular collapse, pulmonary oedema if inadvertently intravascular or too high dose.  • Your setting (robotic/laparoscopic myomectomy) gives fine control, but still you must assume systemic absorption is possible. • The balance is: maximise hemostatic benefit, minimise systemic risk. |
