Effect of Intraoperative Oxytocin Infusion on Reducing the Absorption
Rate of Irrigation Fluid during Hysteroscopic Myomectomy: A Novel
Approach;A clinical Trial
Abstract
Introduction: Uterine leiomyoma is one of the most common benign tumors
in women. Severe bleeding and unstable hemodynamics might occur in
patients undergoing hysteroscopic myomectomy due to excessive irrigation
fluid absorption.The aim of this study was to evaluate the effect of
Intraoperative oxytocin infusion on the absorption of irrigation fluid
in patients undergoing hysteroscopic myomectomy. Methods: In a
randomized double-blind clinical trial, 50 patients aged 25-45 years
with American Society of Anesthesiologists (ASA) class I or II
undergoing hysteroscopic myomectomy were studied. In the study group
(Group O), 250 mL ringer solution containing 15 units of oxytocin was
infused at rate of 125 mL/h; while, the placebo group (Group P) received
250 mL ringer solution containing 1.5 ml of normal saline was infused at
rate of 125 mL/h.Intraoperative hemodynamic alterations, fluid deficit,
declined hemoglobin, hematocrit, sodium and albumin levels from
baseline, complications and incidence of toxicity with the administered
solutions were evaluated at both intraoperative and 24 hours
postoperative phases. Results: The volume of irrigation fluid (P=0.032)
and volume deficit (P=0.034) were significantly lower in the Group O.
The incidence of intraoperative hypotension was significantly lower in
Group O compared to Group P (P=0.019). Serum hematocrit (P=0.043) and
sodium (P=0.026) levels were significantly lower in Group O. Conclusion:
Intraoperative infusion of oxytocin during hysteroscopic myomectomy
might be associated with decreased irrigation fluid absorption and its
associated complications. Therefore, this method could be used to reduce
the complications caused by the absorption of large volumes of
irrigation fluid during hysteroscopic myomectomy