Effect of Intramyometrial Injection of Epinephrine During Abdominal Myomectomy | ||
| Evidence Based Women's Health Journal | ||
| Article 2, Volume 12, Issue 1, February 2022, Pages 8-16 PDF (543.43 K) | ||
| Document Type: Research High lights | ||
| DOI: 10.21608/ebwhj.2018.5540.1007 | ||
| Author | ||
| ziad abouzeid* | ||
| Department of Obstetrics and Gynecology, Faculty of medicine, University of Alexandria | ||
| Abstract | ||
| Aim: This study aimed to assess the effectiveness of intramyometrial injection of epinephrine in reducing blood loss in abdominal myomectomy and to compare it with pericervical tourniquet. Materials and Methods: Randomized controlled study carried on sixty patients suffering from symptomatic uterine fibroids and counseled for abdominal myomectomy. The patients were randomized into 3 groups of twenty each: control, tourniquet and epinephrine groups. A comparative analysis of the intra and postoperative outcomes of these groups was performed assessing the duration of operation, the blood loss and the blood transfusion rate. Results: The epinephrine group had a statistically significant lower values of the fall in haemoglobin level and a significantly lower mean operative blood loss than the tourniquet and the control groups. Furthermore, the mean duration of operation was significantly shorter in the epinephrine group. Conclusion: Intramyometrial injection of a solution of bupivacaine (50 ml of 0.25%) plus epinephrine (0.5 ml of 1 mg/ml) is very effective in reducing intraoperative bleeding during abdominal myomectomy. This solution is significantly more effective than using Foley's urethral catheter as a pericervical tourniquet. However it offers no additional benefits over using a pericervical tourniquet regarding the need for blood transfusion. | ||
| Keywords | ||
| Bupivacaine; epinephrine; myomectomy; pericervical tourniquet; uterine fibroids | ||
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