Local Epinephrine Versus Uterine Artery Tourniquet to Reduce Bleeding During Myomectomy: A Prospective Clinical Trial
Mohammed Khashaba, S., Warda, O., Gibreel, A., Elesawi, M. (2023). Local Epinephrine Versus Uterine Artery Tourniquet to Reduce Bleeding During Myomectomy: A Prospective Clinical Trial. EKB Journal Management System, 13(4), 369-375. doi: 10.21608/ebwhj.2023.231834.1260
Sally Ahmed Mohammed Khashaba; Osama Mahmoud Warda; Ahmed Fathy Gibreel; Maher Elesawi. "Local Epinephrine Versus Uterine Artery Tourniquet to Reduce Bleeding During Myomectomy: A Prospective Clinical Trial". EKB Journal Management System, 13, 4, 2023, 369-375. doi: 10.21608/ebwhj.2023.231834.1260
Mohammed Khashaba, S., Warda, O., Gibreel, A., Elesawi, M. (2023). 'Local Epinephrine Versus Uterine Artery Tourniquet to Reduce Bleeding During Myomectomy: A Prospective Clinical Trial', EKB Journal Management System, 13(4), pp. 369-375. doi: 10.21608/ebwhj.2023.231834.1260
Mohammed Khashaba, S., Warda, O., Gibreel, A., Elesawi, M. Local Epinephrine Versus Uterine Artery Tourniquet to Reduce Bleeding During Myomectomy: A Prospective Clinical Trial. EKB Journal Management System, 2023; 13(4): 369-375. doi: 10.21608/ebwhj.2023.231834.1260

Local Epinephrine Versus Uterine Artery Tourniquet to Reduce Bleeding During Myomectomy: A Prospective Clinical Trial

Evidence Based Women's Health Journal
Article 10, Volume 13, Issue 4, November 2023, Page 369-375  XML PDF (354.8 K)
Document Type: Original Article
DOI: 10.21608/ebwhj.2023.231834.1260
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Authors
Sally Ahmed Mohammed Khashaba1; Osama Mahmoud Warda1; Ahmed Fathy Gibreelorcid 1; Maher Elesawi email orcid 2
1Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University Hospital, Egypt
2Faculty of Medicine, Mansoura University
Abstract
Objective: Despite the availability of interventions for controlling bleeding during myomectomy, the superiority of one over another is still unclear.
Materials and Methods: This prospective study was conducted at Mansoura University Hospital, Mansoura, Egypt, between July 2019 and July 2021, after approval from the Mansoura Faculty of Medicine Institutional Research Board (IRB: MS.19.05.629) on 40 cases divided into two equal groups. Patients in the tourniquet group: A Foley catheter of 16F size surrounded the cervix at the level of the internal os and tightened to occlude the uterine arteries. The epinephrine group: a solution of 1/250,000 epinephrine )produced by dilution of 1 ampule epinephrine(1mg/1ml Epinephrine: chemical industries development (CID), Giza, Egypt) in 250 ml saline( was infiltrated at the myoma bed and beneath the covering myometrium until the infiltrated areas became paler.
Results: The blood loss was significantly lower in the epinephrine group (362.50± 61.12) versus (452.95± 70.72) (p < 0.001). Blood transfusion was non significantly higher in the tourniquet group (55%) versus (25%) (p = 0.053). The operative time was considerably shorter (p < 0.001) in the epinephrine group (36.65±4.38) compared with the tourniquet group (41.65±3.77). The hospital stay wasn’t statistically longer in the tourniquet group compared to the epinephrine group (2(1-3)) (1(1-2)) respectively, (p = 0.147. Fortunately, no cases of hysterectomy or relaparotomy in both groups.
Conclusion: Injecting Epinephrine during myomectomy reduces intraoperative blood loss and blood transfusion and shortens the operative time.
Keywords
Blood loss; epinephrine; myomectomy; tourniquet
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