title: Effect of intravenous ascorbic acid infusion on blood loss during laparoscopic myomectomy: a randomized, double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  Most interventions aimed at reducing bleeding during myomectomy lack sufficient evidence regarding their effectiveness. Recently, it was reported that intraoperative ascorbic acid administration effectively reduced blood loss during abdominal myomectomy. Therefore, this study aimed to investigate whether intravenous ascorbic acid infusion would affect intraoperative blood loss in women undergoing laparoscopic myomectomy.
  
  
  METHODS
  A randomized, double-blind, parallel-group, placebo-controlled trial including 50 women undergoing laparoscopic myomectomy was conducted. Women with ≤4 myomas, ≤9cm in maximum diameter were eligible. The study:control group ratio was 1:1. Starting 30minutes before anesthesia, 2g of ascorbic acid or a placebo were administered for 2hours intraoperatively. Intraoperative blood loss, the primary endpoint, was calculated as the difference between the volume of fluids acquired from suction and that used for irrigation of the abdominal cavity during surgery using constant values.
  
  
  RESULTS
  Among the 50 randomized women, 1 and 3 in the study and control groups, respectively, were excluded due to withdrawal of consent, cancelation of surgery, or non-measurement of the primary endpoint. The baseline and operative characteristics were similar between the study and control groups, as was the intraoperative blood loss (193±204mL vs. 159±193mL, P=0.52). In addition, the operating time (95±29min vs. 110±52min; P=0.50) and decrease in hemoglobin level after surgery (1.9±1.31g/dL vs. 1.4±1.4g/dL; P=0.24) were similar between the study and control groups.
  
  
  CONCLUSIONS
  Intravenous ascorbic acid infusion did not reduce intraoperative blood loss in women undergoing laparoscopic myomectomy.
  
  
  BACKGROUND
  ClinicalTrials.gov, www.clinicaltrials.gov, NCT01715597.
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University, Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
authors.forename: Banghyun
authors.initials: B
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University, Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
authors.forename: Kidong
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong-Si, Gyeonggi-do, Republic of Korea.
authors.forename: Hye Yon
authors.initials: HY
authors.lastname: Cho
authors.affiliation: Rehabilitation Medicine Department, Seoul National University, Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University, Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Suh
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University, Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
authors.forename: Jae Hong
authors.initials: JH
authors.lastname: No
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University, Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
authors.forename: Jung Ryeol
authors.initials: JR
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University, Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Hwang
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University, Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
authors.forename: Sang Hwan
authors.initials: SH
authors.lastname: Do
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University, Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea; Seoul National University, School of Medicine, Seoul, Republic of Korea. Electronic address: ybkimlh@snubh.org.
authors.forename: Yong Beom
authors.initials: YB
authors.lastname: Kim
mesh_terms: D000328:Adult; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D061646:Operative Time; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000009:adverse effects* / Q000379:methods; D014594:Uterine Neoplasms / Q000601:surgery*
chemical_list: D001205:Ascorbic Acid
keywords: Ascorbic acid; Laparoscopy; Operative time; Surgical blood loss; Uterine myomectomy