Alumi Laparoscopic Discussion Board

Regarding Vasopressin dilution
Discussion in 'All Categories' started by Dr Mohammed Morsi - Jun 19th, 2016 2:09 am.
Dr Mohammed Morsi
Dr Mohammed Morsi
Dear Dr Mishra

What should be the ideal dilution of vasopressin used to prevent bleeding in laparoscopic myomectomy

re: Regarding Vasopressin dilution by Dr R K Mishra - Jun 19th, 2016 4:29 am
#1
Dr R K Mishra
Dr R K Mishra
Dear Dr Morsi

Vasopressin has sometime very bad effect on human body. It induce sudden increase in blood pressure causes a vagal mediated decrease in the heart rate. The vasoconstrictive effects of vasopressin may, simultaneously, cause coronary artery vasospasm, resulting in cardiac ischemia.
In many of the cases of laparoscopic myomectomy there are reports of vasopressin-induced bradycardia and cardiac arrest, the dose of vasopressin administered, as in the case just described, exceeded 5 units, or the vasopressin was accidentally injected into a vessel unintentionally.

To make sure vasopressin is safe for your patient, you should keep in mind that patient should not have:

1. Coronary artery disease;
2. Kidney disease;
3. Asthma;
4. Migraine headaches; or
5. Epilepsy or other seizure disorder.

The optimal dose and dilution of vasopressin continues to be controversial however 5 international unit with 20ml of saline can be used in myomectomy. Care should be taken that it should not accidently get injected into the vain and blebbing of hydrodissection should be visible. Once the vasopressin effect will start it will be visible like marble white appearance.

Severe bradycardia occasionally induced by vasopressin infiltration has been described in such operations as myomectomy and cervical conization and even in unruptured ectopic pregnancy, The total administered dose should be as small as possible. We recommend that careful monitoring is essential for hemostasis of the uterus. In addition, during use of vasopressin during laparoscopic surgery a close communication between the anesthesiologist and the gynecologist is very important to identify and treat immediately this unfortunate complication.

Dr R K Mishra
re: Regarding Vasopressin dilution by Dr Alisha - Sep 10th, 2016 11:07 pm
#2
Dr Alisha
Dr Alisha
Unfortunately Vasopressin is not approved by FDA for myomectomy so we can not used it.
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