Comparing the effect of intramural injection of vasopressin and oxytocin for hemorrhage reduction in laparoscopic myomectomy: A randomized double-masked study

Background: Uterine leiomyoma is the most prevalent benign gynecologic tumor. This study compared the effectiveness and safety of vasopressin versus oxytocin intramyometrial injections in reducing blood loss during laparoscopic myomectomy. Methods: In this randomized double-masked study, forty-six women were randomly assigned to receive either a sub-capsular intramyometrial injection of 10 IU oxytocin, diluted in 20 ml saline solution or a sub-capsular intramyometrial injection of 20 IU vasopressin at the time of uterine incision. Results: The primary outcome measure was intraoperative bleeding, which was considerably lower in the group receiving vasopressin (97.73 82.53 vs 187.83 129.33, P value=0.008). No significant difference between the two groups was observed regarding hemoglobin reduction from baseline levels or the need for transfusion. During the operation, patients receiving vasopressin injections experienced a lower pulse rate than those receiving oxytocin injections (74.95 bpm vs 81.67 bpm, P value=0.02). Conclusion: Vasopressin appears to be an effective option for bleeding reduction during laparoscopic myomectomy procedures; however, because of its cardiac effects, close uterine and cardiac monitoring and careful collaboration between the anaesthesiologist and the gynecologist are required. We can reserve oxytocin injections for cases where vasopressin is contraindicated due to cardiopulmonary problems.