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 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 Gibreel 1; Maher Elesawi 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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