Bradycardia and cardiac arrest caused by intramyometrial injection of vasopressin during a laparoscopically assisted myomectomy.
BACKGROUND
Vasopressin is often used locally to reduce blood loss during surgery. The use of a local infiltration of a low concentration of vasopressin, less than 0.05-0.3 units/mL, has been considered to be safe. The use of low-dose vasopressin is not free of side effects, and it can also sometimes cause lethal complications.


METHODS
In a healthy woman with multiple uterine myomas, we experienced a case of sudden cardiac arrest immediately after the intramyometrial injection of vasopressin at a total dose of 11 units (0.2 units/mL). The patient was successfully resuscitated.


CONCLUSIONS
Local intramyometrial infiltration of low-dose vasopressin may cause lethal cardiopulmonary complications.
Hobo
Rutsuko
R
From the Department of Gynecology, Yotsuya Medical Cube; and the Center of Human Reproduction, Sanno Hospital, Tokyo, Japan.
Netsu
Sachiko
S
Koyasu
Yasuki
Y
Tsutsumi
Osamu
O
D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001919:Bradycardia / Q000139:chemically induced*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced*; D006490:Hemostatics / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects / Q000379:methods; D010535:Laparoscopy; D018231:Leiomyomatosis / Q000601:surgery; D014667:Vasopressins / Q000008:administration & dosage / Q000009:adverse effects*
D006490:Hemostatics; D014667:Vasopressins