The effect of intrauterine instillation of E-Aminocaproeic Acid during hysteroscopic operations in the management of intractable uterine hemorrhage: A Randomized Clinical Trial
چکیده
The main objective of this study is to determine the effect of intrauterine instillation of e-aminocaproic acid (EACA) during hysteroscopic operations in the management of uterine bleeding. Seventy participants have been considered for each group in a double blind, RCT in a teaching hospital in Tabriz University of Medical Sciences from Oct. 2010 to Dec. 2012. Patients with a history of abnormal uterine bleeding accompanied submucous myoma less than 4 cm in diameters, were included. Both groups received dextrose 5% as a distending media. Only in group 1, EACA acid added to injected media. Intrauterine bleeding during hysteroscopic surgery was determined by visual scale. Intraoperative bleeding, duration of surgery, the volume of injected media, and success in completion of operation were considered as primary outcomes and postoperative complication including gastrointestinal side effects, uterine bleeding, and duration of hospital stay are considered as secondary outcomes. Of 140 patients, 120 of them completed the study. Patients in group 1 had less intraoperative intrauterine bleeding compared to group 2 (p =0.02). There was no statistically significant at the mean operation time (P=0.45). Statistically significant differences were found between the two groups to create a very clear operative field.[RR= 2.82 95%CI (1.76 - 4.5) (P<0.001)]. There was no significant intraoperative and postoperative complications in both groups (p>0.05). The results showed that EACA is effective in reducing hysterocopic intraoperative uterine bleeding. EACA makes a clear and un-blurred environment to achieve good surgical results. EACA is suggested for other uterine endoscopic surgeries.