title: Effect of uterotonics on intra-operative blood loss during laparoscopy-assisted vaginal hysterectomy: a randomised controlled trial.
abstract: OBJECTIVE
  To investigate the effectiveness of uterotonics misoprostol and oxytocin on reducing blood loss during laparoscopy-assisted vaginal hysterectomy (LAVH).
  
  
  METHODS
  Randomised, double-blind placebo-controlled trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred and seventy-three women underwent LAVH for symptomatic uterine myomas and were randomly allocated to uterotonics (n = 91) or placebo (n = 82).
  
  
  METHODS
  Women underwent LAVH for symptomatic uterine myomas and were randomly assigned to receive either rectal misoprostol (400 microg) and intravenous oxytocin (10 IU/hour) or placebo during LAVH. Parameters related to surgical outcome were compared.
  
  
  METHODS
  The main outcome measure was intra-operative blood loss.
  
  
  RESULTS
  Patient characteristics and indications for LAVH were similar in both groups. Mean [SD] for all continuous data estimated weight of blood loss (198.1 [123.2] vs 396 [337.6] g; P < 0.0001), mean operation time (106.2 [39.4] vs 116.6 [34.6] minutes; P = 0.02), mean change in haemoglobin (1.5 [1.0] vs 1.9 [1.2] g/dL; P = 0.02) and haematocrit levels (4.8 [2.9]% vs 5.8 [3.6]%; P = 0.04) and mean hospitalisation period (3.3 [0.8] vs 3.9 [1.1] days; P < 0.0001), which were significantly less in the group given rectal misoprostol and intravenous oxytocin than in the placebo group, respectively. There was no significant difference in complications and side effects between the two groups (P > 0.05).
  
  
  CONCLUSIONS
  Combined rectal misoprostol and intravenous oxytocin is a feasible and effective method of reducing blood loss and operation time in LAVH.
authors.affiliation: Department of Obstetrics and Gynecology, Tri-service General Hospital, National Defense Medical Center, National Defense University, Neihu, Taipei, Taiwan.
authors.forename: Fung-Wei
authors.initials: FW
authors.lastname: Chang
authors.forename: Mu-Hsien
authors.initials: MH
authors.lastname: Yu
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Ku
authors.forename: Chi-Huang
authors.initials: CH
authors.lastname: Chen
authors.forename: Gwo-Jang
authors.initials: GJ
authors.lastname: Wu
authors.forename: Jah-Yao
authors.initials: JY
authors.lastname: Liu
mesh_terms: D000285:Administration, Rectal; D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D007262:Infusions, Intravenous; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery; D007902:Length of Stay; D008875:Middle Aged; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage*; D011247:Pregnancy; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin