A comparative study between the efficacy of local intra-myometrial injection of vasopressin and octreotide acetate, in reducing blood loss during myomectomy

Badawy, Amira Mohammed

doi:10.18203/2320-1770.ijrcog20174399

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…[ 15 ] reported that vasopressin (20 units, 1 unit/ml) decreased the blood loss during myomectomy in 26 patients without significant cardiovascular complications and the findings were shown by other studies. [ 16 17 ]…”

Section: Discussionmentioning

confidence: 99%

Assessment of the perioperative effect of vasopressin in patients undergoing laparoscopic myomectomy

Soliman

Yacoub

Elbiaa

2021

Indian Journal of Anaesthesia

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Background and Aims: Myomectomy is associated with perioperative bleeding. The aim of the study is to evaluate the effect of intramyometrial vasopressin on blood loss and the associated cardiovascular complications during myomectomy. Methods: The study included 194 patients classified into two groups- 1) Vasopressin group: the vasopressin was diluted as 0.1 unit/ml and 15 ml was injected by the surgeon in the plane between the myometrium and the myoma. 2) Control group: The patients received an equal amount of normal saline. The monitored parameters included the amount of blood loss, required blood transfusion, heart rate, mean arterial blood pressure, the incidence of hypertension, hypotension, bradycardia, tachycardia, electrocardiogram (ECG) changes and the blood troponin I level. Results: The heart rate decreased significantly in both groups, but the decrease was lower with vasopressin than the control group through the time points T3 to T5 ( P < 0.05) The mean arterial blood pressure increased significantly in both groups, but the increase was higher with vasopressin than the control group through T3 to T5 ( P < 0.05). The amount of blood loss decreased significantly with vasopressin than the control groups ( P = 0.001). The number of transfused packed red blood cells was lower with vasopressin than the control group ( P = 0.001). The incidence of hypertension, bradycardia and atrial extrasystole was higher with vasopressin than the control group ( P = 0.005, P = 0.012, P = 0.033, respectively). Conclusion: Intramyometrial vasopressin decreases blood loss and blood transfusion, but it is associated with cardiovascular complications that may be serious as reported in other studies. Therefore, anaesthesiologists and gynaecologists must follow the precautions to avoid and minimise the incidence of complications with intramyometrial vasopressin.

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Section: Discussionmentioning

confidence: 99%

Assessment of the perioperative effect of vasopressin in patients undergoing laparoscopic myomectomy

Soliman

Yacoub

Elbiaa

2021

Indian Journal of Anaesthesia

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Prophylactic vasopressin to reduce intraoperative blood loss and associated morbidities during myomectomy: A systematic review and meta-analysis of 11 controlled trials

Alomar¹,

Abu‐Zaid²,

Jamjoom³

et al. 2022

Journal of Gynecology Obstetrics and Human Reproduction

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A systematic review and meta-analysis of efficacy of vasopressin as a vasoconstrictive and uterotonic drug in laparoscopic myomectomy

Balachandran,

Mishra,

Effie

et al. 2024

Journal of Minimal Access Surgery

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Introduction: Laparoscopic myomectomy is a commonly performed operation with fast recovery and excellent results. However, haemorrhagic nature of the operation mandates us to use variety of vasoconstrictive and uterotonic agents. Amongst which, one of them is vasopressin. It is a synthetic antidiuretic hormone analogue which has been in common use as a vasoconstrictive agent in various surgical procedures including laparoscopic myomectomy. Methods: A meta-analysis of randomised controlled trials published from 2013 to 2023 (10 years) comparing the use of vasopressin against other drug or placebo or different doses of vasopressin was performed. The outcome measures were intraoperative blood loss, need for blood transfusion, difference in the haemoglobin (Hb) and haematocrit (Hct). Results: We identified 176 articles through the study search, amongst which 12 articles were included for the meta-analysis. There was a significant heterogeneity in the studies with moderate risk of bias in eight studies and low risk of bias in four studies. Compared to placebo, vasopressin showed significantly lower odds need of blood transfusion (odds ratio [OR] 0.28, 95% confidence interval [CI]: 0.13–0.61, P = 0.002) and significantly lower pre–post fall in Hb (OR −3.12, 95% CI: −4.63–−1.60, P < 0.0001). However, there was no statistically significant difference in intraoperative blood loss (OR −0.56 (95% CI: −2.04–0.92, P = 0.46) and pre–post fall in Hct (OR −0.94, 95% CI: −1.96–0.07, P > 0.05). Compared to other drug (epinephrine, misoprostol and octreotide acetate), vasopressin showed no significant superiority in controlling blood loss (P > 0.05). Even the two doses of vasopressin (dilute vs. concentrated) showed no statistically significant difference between surgical blood loss and need for blood transfusion (P > 0.05). Conclusion: Vasopressin is an efficacious drug to be used for controlling blood loss, decreasing blood transfusion requirement and maintaining Hb and Hct during laparoscopic myomectomy.

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A comparative study between the efficacy of local intra-myometrial injection of vasopressin and octreotide acetate, in reducing blood loss during myomectomy

Cited by 3 publications

References 17 publications

Assessment of the perioperative effect of vasopressin in patients undergoing laparoscopic myomectomy

Assessment of the perioperative effect of vasopressin in patients undergoing laparoscopic myomectomy

Prophylactic vasopressin to reduce intraoperative blood loss and associated morbidities during myomectomy: A systematic review and meta-analysis of 11 controlled trials

A systematic review and meta-analysis of efficacy of vasopressin as a vasoconstrictive and uterotonic drug in laparoscopic myomectomy

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