A Comparative Study To Assess Blood Loss During Abdominal Myomectomy By Tourniquet Application Versus Intramyometrial Vasopressin Injection

ABSTRACT

Objective: The objective of this study was to determine the efficacy of applying uterine artery tourniquet and intramyometrialvasopressin injection to reduce intraoperative blood loss during abdominal myomectomy.Methods: A comparative interventional study comparing parameters in the two groups of patients containing 24 each whereone received tourniquet application and other received intramyometrial vasopressin.Results: Pre-operative hemoglobin (Hb) was comparable in both mean 10.5 ± 0.50 g/dl in tourniquet group and 10.5 ± 0.47 g/dlin vasopressin group. Pre-operative hematocrit (Hct) was also comparable in both mean 31.8 ± 1.44% in tourniquet groupand 31.7 ± 1.51% in vasopressin group. Mean operative time was 49.0 ± 10.33 min in tourniquet group and 48.8 ± 9.62 min invasopressin group which was statistically indifferent. Amount of mean blood loss in the tourniquet group was 467.9 ± 74.50 cc and356.45 ± 58.35 cc in vasopressin group which is significantly higher in former. Post-operative day 3 Hb was lower in tourniquetgroup 8.94 ± 0.52 g/dl than 9.45 ± 0.52 g/dl in vasopressin group. Reduction in Hb postoperatively was more in tourniquetgroup 1.43 ± 0.45 g/dl than vasopressin group 0.92 ± 0.20 g/dl. Reduction in Hct postoperatively was more (4.82 ± 1.4%) intourniquet group than in vasopressin group (2.74 ± 0.62%). Blood transfusion was required 5 (20.83%) cases in tourniquetgroup, but only in 2 (8.33%) cases of vasopressin group though it was statistically indifferent between both groups.Conclusion: Application of tourniquet had more mean operative time, intraoperative blood loss, and requirement of bloodtransfusion. There is more reduction in Hb and Hct postoperatively in tourniquet application.