Pericervical Tourniquet versus Intra Operative Carbetocin in Reducing Blood Loss in Myomectomy by Laparotomy

Background: The use of paracervical tourniquet and intraoperative Carbetocin in Myomectomy via laparotomy has shown efficacy in mitigating blood loss.Objectives: This study aimed to conduct a comparative analysis of the Pericervical tourniquet and intraoperative intravenous (IV) carbetocin in terms of their efficacy in minimizing blood loss during abdominal Myomectomy. Methods: The current study was implemented as a clinical trial that was randomized and controlled, involving a cohort of 60 female patients aged 18-45 years. These patients were diagnosed with uterine leiomyoma and had been recommended for abdominal Myomectomy. The patients were specifically diagnosed with interstitial leiomyoma, fibroids measuring between 3cm and 7cm in size, and multiple leiomyomas ranging from 3 to 7 cm leiomyomas. The patients were divided into two groups of equal size. In Group A, a pre-cervical tourniquet was applied, whereas Group B received intraoperative administration of 100 mg of carbetocin intravenously. Results: The levels of postoperative hemoglobin (Hb) were significantly lower in group B as opposed to group A (P=0.037). Operative time, incidence of blood transfusion, and estimated blood loss were not significantly different between the two groups. Duration of hospital stay, incidence of nausea, vomiting, flushing, dizziness, and hypotension was significantly higher in group B than in group A (P<0.05). Conclusion: The administration of carbetocin during open Myomectomy, whether administered intravenously or intramyometrially, has been shown to reduce intraoperative blood loss. In our investigation, the utilization of a uterine artery tourniquet appears to be a more efficacious approach, as it effectively reduces bleeding and facilitates appropriate hemostasis during this surgical procedure.