Intramyometrial injection of vasopressin in laparoscopic supracervical hysterectomy.
OBJECTIVE
To investigate the effectiveness of vasopressin in reducing blood loss in laparoscopic supracervical hysterectomy (LSH).


METHODS
Retrospective chart analysis (Canadian Task Force classification II-2).


METHODS
University-affiliated teaching hospital.


METHODS
In all, 143 women who had LSH for benign gynecologic disease.


METHODS
Laparoscopic supracervical hysterectomy.


RESULTS
From January 2001 through December 2006, 143 patients were identified who had consecutive, successful LSH performed by different gynecologic laparoscopists. There were no exclusion criteria. The patients were divided into 2 groups based on whether intramyometrial vasopressin injection was used intraoperatively to reduce blood loss; 77 (54%) patients received intramyometrial vasopressin injection and 66 (46%) did not. The 2 groups were compared with regard to blood loss, operating time, uterine weight, hospital stay, concomitant salpingo-oophorectomy, perioperative complications, and patient characteristics including age, gravity, parity, body mass index, surgical history, and number of cesarean deliveries. No difference existed in the first postoperative day decrease in hemoglobin between the vasopressin and control group (2.3 +/- 0.9 vs 2.1 +/- 1.2 g/dL, respectively, p = .56). No significant difference existed between the groups with respect to operating time (146.9 +/- 52.6 vs 131.9 +/- 42.8 min, p = .07) or uterine weight (145.4 +/- 121.8 vs 119.5 +/- 66.9 g, p = .14). All other parameters and patient characteristics were similar between the 2 groups except for the duration of hospital stay. Patients who received intramyometrial vasopressin injection experienced a slightly longer duration of hospital stay (1.4 +/- 0.7 vs 1.1 +/- 0.4 days, p = .02).


CONCLUSIONS
Our study does not support the routine use of intramyometrial vasopressin injection during LSH to reduce blood loss.
Ghomi
Ali
A
Department of Gynecology-Obstetrics, University at Buffalo, The State University of New York, Buffalo, New York 14222, USA. alighomi@buffalo.edu
Makhlouf
Fadi
F
Kasturi
Seshadri
S
Einarsson
Jon Ivar
JI
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D015552:Injections, Intralesional; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D012189:Retrospective Studies; D014667:Vasopressins / Q000008:administration & dosage*
D006490:Hemostatics; D014667:Vasopressins