title: Bradycardia and severe vasospasm caused by intramyometrial injection of vasopressin during myomectomy.
abstract: Vasopressin is often used locally to reduce blood loss during surgery. Vasopressin has longest clinical effect, but its systemic effects may be profound and pose significant challenges for the anesthesiologist and it can also sometimes cause lethal complications. The loss of peripheral pulse along with bradycardia, non-measurable arterial blood pressure, and cardiac complications have been reported after myometrial injection of vasopressin. Here, we describe a patient with multiple uterine myomas who developed severe bradycardia, non-measurable blood pressure by non-invasive means and loss of peripheral pulse after myometrial injection of vasopressin at a total dose of 20 units (1 unit/ml) with documentation of severe peripheral arterial vasospasm and increased proximal blood pressure. The patient was successfully resuscitated.
authors.affiliation: Department of Anesthesia and Critical Care, Smt. K. M. Mehta and Smt. G. R. Doshi Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India.
authors.forename: Bina P
authors.initials: BP
authors.lastname: Butala
authors.affiliation: Department of Anesthesia and Critical Care, Smt. K. M. Mehta and Smt. G. R. Doshi Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India.
authors.forename: Veena R
authors.initials: VR
authors.lastname: Shah
authors.affiliation: Department of Anesthesia and Critical Care, Smt. K. M. Mehta and Smt. G. R. Doshi Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India.
authors.forename: Beena K
authors.initials: BK
authors.lastname: Parikh
authors.affiliation: Department of Anesthesia and Critical Care, Smt. K. M. Mehta and Smt. G. R. Doshi Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India.
authors.forename: J
authors.initials: J
authors.lastname: Jayaprakash
authors.affiliation: Department of Anesthesia and Critical Care, Smt. K. M. Mehta and Smt. G. R. Doshi Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India.
authors.forename: Jasmita
authors.initials: J
authors.lastname: Kalo
keywords: Bradycardia; intramyometrial injection; myomectomy; vasopressin