Control of Blood Loss During Gynecologic Surgery

The Effect of Anaesthesia, Hypotension, and Epidural Analgesia on Blood Loss in Surgery for Pelvic Floor Repair

“…The wide range of bleeding is an invariable feature of all blood loss investigations. It occurs in vaginal surgery (Buchman, 1953;Lazar and Kreiger, 1959;Dillon, 1962;Copenhaver, 1964), prostatectomy (Bodman, 1959), cardiac surgery (Thornton et al, 1963), obstetrics (Wallace, 1967) and paediatrics (Jones, 1962). Hercus and bis associates measured blood loss in 412 major operations.…”

Abdominal Myomectomy: Reducing the Risk of Hemorrhage

“…In addition to its antidiuretic effect, vasopressin induces smooth muscle contraction in the gastrointestinal tract and the vascular bed. In particular, it has been found to have a potent vasoconstrictive effect on the nonpregnant uterus when injected locally [35][36][37] It has a plasma half-life of 10 to 20 minutes and has been used effectively as a hemostatic agent during myomectomy [36][37][38] A dilute solution of vasopressin (10 U/100 ml of saline) is injected diffusely into the myometrium surrounding the myomas to be removed. Care should be taken to avoid injecting the solution directly into vascular channels, and no more than 30 ml per patient is recommended due to potential side effects.…”

“…This effect is potentiated in patients taking tricyclic antidepressants. 35,36 The most common complication following the use of vasopressin is late postoperative bleeding. 36 However, proponents of this agent claim that arterial bleeding is not masked by vasopressin and must be controlled intraoperatively with suture ligatures.…”

“…35,36 The most common complication following the use of vasopressin is late postoperative bleeding. 36 However, proponents of this agent claim that arterial bleeding is not masked by vasopressin and must be controlled intraoperatively with suture ligatures. 36 Furthermore, due to the short half-life of vasopressin, the hemostatic effect is only observed for 20 to 30 minutes, which should be well before abdominal closure.…”

“…36 However, proponents of this agent claim that arterial bleeding is not masked by vasopressin and must be controlled intraoperatively with suture ligatures. 36 Furthermore, due to the short half-life of vasopressin, the hemostatic effect is only observed for 20 to 30 minutes, which should be well before abdominal closure. Opponents claim that vasopressin simply delays bleeding, gives a false sense of security, and is not particularly effective for larger myomas.…”