Dilute versus concentrated vasopressin administration during laparoscopic myomectomy: a randomised controlled trial

Cohen, Sarah L.; Senapati, S.; Gargiulo, Antonio R.; Srouji, Serene S.; F, Tu; Solnik, Jonathon; Hur, H.-C.; Vitonis, Allison F.; Jónsdóttir, Guðrún; Wang, Karen; Einarsson, Jon I.

doi:10.1111/1471-0528.14179

Cited by 25 publications

(20 citation statements)

References 17 publications

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“…No difference in intraoperative blood loss was demonstrated between the two groups. No vasopressin-related complications were identified in either group 7…”

Section: Discussionmentioning

confidence: 83%

Risk of vasopressin use: a case of acute pulmonary oedema, post intramyometrial infiltration of vasopressin in laparoscopic myomectomy

et al. 2019

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A 34-year-old patient underwent a laparoscopic myomectomy, complicated by a profound episode of bradycardia and hypotension following intramyometrial infiltration of vasopressin (20 IU), promptly corrected with intravenous ephedrine (6 mg) and glycopyrrolate (200 µg). At extubation, pink frothy fluid was noted in the endotracheal tube; she was visibly distressed, desaturated to 89% in air and was coughing up pink stained fluid. Acute pulmonary oedema secondary to vasopressin was suspected. A tight-fitting oxygen mask (100%) with positive end expiratory pressure was applied and intravenous furosemide (20 mg) and diamorphine (4 mg, 1 mg increments) were administered to facilitate diuresis and oxygenation. Chest X-ray confirmed acute pulmonary oedema. Arterial blood gas demonstrated type 2 respiratory failure. Over 12 hours, the oxygen was weaned to 1 L/min. She demonstrated excellent diuresis. Troponin and brain-natriuretic peptide were elevated, but echocardiogram was normal. The cardiology diagnosis was vasopressin-induced coronary vasospasm, precipitating acute pulmonary oedema. She was discharged home on day 5.

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“…No difference in intraoperative blood loss was demonstrated between the two groups. No vasopressin-related complications were identified in either group 7…”

Section: Discussionmentioning

confidence: 83%

Risk of vasopressin use: a case of acute pulmonary oedema, post intramyometrial infiltration of vasopressin in laparoscopic myomectomy

et al. 2019

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“…We avoided misoprostol, which is routinely given to reduce bleeding during myomectomy [22], due to concerns about uterine contraction leading to uterine rupture or uncontrolled bleeding from the percreta site. Intrauterine vasopressin, routinely used during myomectomy [32], may be used in surgically managed PAS to reduce intraoperative bleeding. We did not use an intrauterine manipulator due to concerns about disrupting the placenta prior to securing the uterine vascular supply, but several other options exist to provide cephalad deviation and delineation of the cervix.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic hysterectomy to manage uterine rupture due to placenta percreta in the first trimester: A case report

Lee

Zahn

Knittel

et al. 2020

Case Reports in Women's Health

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Placenta percreta causing uterine rupture is a rare complication of pregnancy. It is most commonly diagnosed after the second trimester and can lead to significant morbidity necessitating abdominal hysterectomy of a gravid or immediately postpartum uterus. We describe a patient who presented with abdominal pain at 13 weeks of gestation and was diagnosed with placenta percreta during laparoscopy for presumed appendicitis. Intraoperatively, placenta was seen perforating the uterine fundus and 1 l of hemoperitoneum was evacuated. However, the uterus was hemostatic and the patient was stable, so the procedure was terminated. The patient was then transferred to a tertiary care center, where she ultimately underwent an uncomplicated laparoscopic gravid hysterectomy. We conclude that placenta percreta can occur in the first trimester even in patients without traditional risk factors. In stable patients, it is appropriate to consider minimally invasive hysterectomy with utilization of specific techniques to minimize intraoperative blood loss.

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“…13 Another RCT by Cohen et al comparing different dilutions of vasopressin-200 ml of diluted vasopressin solution (20 U in 400 ml saline), and 30 ml of concentrated vasopressin solution (20 U in 60 ml normal saline) found no significant difference in blood loss or change in HCT levels in both the groups. 14…”

Section: Discussionmentioning

confidence: 99%

Sudden bradycardia and impending cardiac arrest by intra-myometrial vasopressin in laparoscopic myomectomy: a case report and review of literature

Madaan

Baghotia

Soni

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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Dilute versus concentrated vasopressin administration during laparoscopic myomectomy: a randomised controlled trial

Abstract: This randomised trial failed to show benefit of high-volume dilute vasopression.

Cited by 25 publications

References 17 publications

Risk of vasopressin use: a case of acute pulmonary oedema, post intramyometrial infiltration of vasopressin in laparoscopic myomectomy

Risk of vasopressin use: a case of acute pulmonary oedema, post intramyometrial infiltration of vasopressin in laparoscopic myomectomy

Laparoscopic hysterectomy to manage uterine rupture due to placenta percreta in the first trimester: A case report

Sudden bradycardia and impending cardiac arrest by intra-myometrial vasopressin in laparoscopic myomectomy: a case report and review of literature

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