Vasopressin as an etiologic factor for infection in gynecologic surgery: a randomized double-blind placebo-controlled trial.
OBJECTIVE
The purpose of this study was to evaluate the risk of pelvic infection with the use of vasopressin at time of vaginal hysterectomy with a randomized controlled trial.


METHODS
Women who underwent vaginal hysterectomy and agreed to participate were randomly assigned to pericervical injections of vasopressin or normal saline solution. Surgeons and patients were blinded to the injected substance. Power analysis revealed that a sample size of 116 patients would be sufficient to detect a 4-fold difference in pelvic infection rates between the 2 groups, with 90% power and a probability value of.05.


RESULTS
Analysis with 117 patients found no difference in infection rate between the normal saline solution group and the vasopressin groups (7.3% vs 1.6%; P =.19). Estimated blood loss (312 +/- 222 mL vs 446 +/- 296 mL; P =.006) and change in hemoglobin and hematocrit levels (2.1 +/- 1.4 gm vs 2.9 +/- 1.4 gm; P: =.02; and 6.7% +/- 3.4% vs 8.5% +/- 3.8%; P =.01; vasopressin versus normal saline solution, respectively) were significantly less in the vasopressin group. There were no significant differences in interval blood pressure measurements after vasopressin administration between the 2 groups.


CONCLUSIONS
The use of vasopressin during vaginal hysterectomy does not increase the risk of pelvic infection, does decrease operative blood loss, and does not significantly affect blood pressure.
Kammerer-Doak
D N
DN
Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, USA. dorothy.kammerer-doak@lovelace.com
Rogers
R G
RG
Johnson Maybach
J
J
Traynor Mickelson
M
M
D000328:Adult; D016063:Blood Loss, Surgical / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects; D002584:Cervix Uteri; D004311:Double-Blind Method; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007267:Injections; D008875:Middle Aged; D010919:Placebos; D012307:Risk Factors; D012965:Sodium Chloride / Q000494:pharmacology; D013530:Surgical Wound Infection / Q000139:chemically induced*; D014667:Vasopressins / Q000009:adverse effects*
D010919:Placebos; D014667:Vasopressins; D012965:Sodium Chloride