Vasopressin to Control Blood Loss during Hysterectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

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Prophylactic tranexamic acid to reduce blood loss and related morbidities during hysterectomy: a systematic review and meta-analysis of randomized controlled trials

“…Two RCTs are currently in progress ( ClinicalTrials.gov , NCT04760301 and NCT02911831). A recent meta-analysis by Hafidh et al [ 49 ] showed that prophylactic vasopressin administration reduced intraoperative blood loss compared with normal saline. Hence, future research should explore the clinical utility of intraoperative blood control during hysterectomy in a head-to-head comparison between TXA and other active competitors (e.g., vasopressin).…”

Perioperative managment for gynecological surgery in accelerated rehabilitation programme

“…For open myomectomy, a combination of uterotonics and peripheral vasoconstrictors is required to effectively reduce blood loss. 63 Minimising intraoperative blood loss during hysterectomy is crucial to reduce perioperative morbidity. The aim of the Hafidh B study was to conduct a systematic review and meta-analysis of seven randomised controlled trials comparing vasopressin and saline for controlling intraoperative blood loss during vaginal and abdominal hysterectomy.…”

“…However, there was no significant difference between the two groups in terms of mean operative time, mean postoperative haemoglobin change, mean length of hospital stay, incidence of fever, pelvic infections, perioperative blood transfusion, and perioperative complications. 63 According to Ferrari F. et al, the use of an enhanced recovery protocol after gynaecologic surgery leads to a shorter length of stay, regardless of the surgical access and type of gynaecological disease. 31,64 The issue of probes and drains during surgery remains controversial, and the consensus suggests abandoning a routine approach to these procedures.…”