Comparison of misoprostol and hypotensive anesthesia on blood loss during myomectomy

Abstract

Uterine myoma is the most common benign tumor in women of reproductive age, with an estimated prevalence of 15-50% after the age of 35. Uterine fibroids can be controlled with surgery or medication, But myomectomy seems to be a safe and effective procedure This procedure is associated with known risks, including bleeding. Various treatments have been proposed to reduce blood loss (including preoperative GnRH agonist use, tourniquet techniques, bilateral uterine and/or ovarian artery ligation, intra-myometrial vasopressin injection, and hypotensive anesthesia) during myomectomy, but it is still an important challenge for gynecological surgeons. Therefore, in this study, we investigated the control of bleeding by comparing misoprostol and hypotensive anesthesia during myomectomy.

Methods: 94 patient’s candidates for myomectomy surgery were included in the study and divided into two groups, in the first group, bleeding was controlled with hypotensive anesthesia using labetalol, and the second group received a sublingual misoprostol 400 μg before entering the operating room. In our study, the controlled parameters include the amount of blood loss, required blood transfusion, heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, hemoglobin level 6 and 24 hours after surgery, operation time and hospitalization period. data collected with SPSS software, Windows version. 20 cases were analyzed.

Results: In the present study, there was no statistically significant difference between the studied groups in terms of age, weight, number of pregnancies, number and location of myoma. Systolic, diastolic, mean arterial blood pressure and heart rate in the hypotensive anesthesia group were significantly lower than the group receiving misoprostol (p=0.001). Bleeding in the hypotensive anesthesia group was significantly less compared to the sublingual misoprostol group (p=0.01). Hemoglobin drop after surgery (p=0.03), duration of surgery (p=0.01), hospital stay (p=0.05) was less in hypotensive anesthesia group.