Journal d'anesthésiologie clinique : accès libre

Vigilant approach to intramyometrial vasopressin in Obstetrics- a Case report

Abstract

Trishagni Talukdar, Ahmad Zahid

Uterine leiomyomas, commonly called fibroids are benign tumours of uterine myometrium composed of smooth muscle with variable amount of connective tissue. It is the commonest tumour of the female pelvic organ. ¹. As it is vascular tumour, many a times Myomectomy leads severe intraoperative blood loss. It is estimated that the average volume of blood loss during abdominal myomectomy ranges between 200 – 400 ml, ^2,3,4 with blood loss greater than 1000 ml considered as major blood loss.⁵ Vasopressin is a synthetic analogue of the anti-diuretic hormone, has a V1 receptor agonistic action thereby causes vasoconstriction . Intramyometrial injection  of vasopressin helps to reduce significant intraoperative blood loss.  However, it is not devoid of side effects and sometimes might cause very serious  complications like  arrhythmias, bradycardia, pulmonary oedema, and cardiac arrest. Here we  are presenting a case report of sudden severe bradycardia caused by  intramyoma diluted vasopressin injection and discussion on management of such patients.