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Safety and efficacy of lidocaine plus epinephrine on intraoperative bleeding in abdominal myomectomy: A double‐blind clinical trial

BACKGROUND: Uterine fibroid is a common benign pelvic tumor and abdominal myomectomy may cause excessive intraoperative bleeding, which may lead to adverse outcomes. OBJECTIVE: This study was planned to evaluate the effectiveness of the injection of lidocaine plus epinephrine to reduce intraoperativ...

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Autores principales: Mansour‐Ghanaei, Mandana, Hosseinzadeh, Fatemeh, Sharami, Seyedeh Hajar, Biazar, Gelareh, Noori, Fatemeh, Asgari‐Ghalebin, Seyed Mohammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8905574/
https://www.ncbi.nlm.nih.gov/pubmed/35284653
http://dx.doi.org/10.1002/hsr2.551
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author Mansour‐Ghanaei, Mandana
Hosseinzadeh, Fatemeh
Sharami, Seyedeh Hajar
Biazar, Gelareh
Noori, Fatemeh
Asgari‐Ghalebin, Seyed Mohammad
author_facet Mansour‐Ghanaei, Mandana
Hosseinzadeh, Fatemeh
Sharami, Seyedeh Hajar
Biazar, Gelareh
Noori, Fatemeh
Asgari‐Ghalebin, Seyed Mohammad
author_sort Mansour‐Ghanaei, Mandana
collection PubMed
description BACKGROUND: Uterine fibroid is a common benign pelvic tumor and abdominal myomectomy may cause excessive intraoperative bleeding, which may lead to adverse outcomes. OBJECTIVE: This study was planned to evaluate the effectiveness of the injection of lidocaine plus epinephrine to reduce intraoperative bleeding in abdominal myomectomy. METHODS: During October 2019 and May 2020, 60 eligible women with uterine fibroids were enrolled in a randomized controlled trial. Our patients were divided into two groups of lidocaine plus epinephrine defined as Group L and placebo defined as Group P. In group L, lidocaine 3 mg/kg plus 0.5 ml of adrenaline which reached to 50 cc with saline solution and in group P, 50 ml of normal saline was used. Both the combined solution and normal saline were infiltrated to the serous and myometrium above and around the fibroid before incision. Patients' demographic data, total operative time, hemoglobin changes, and the degree of surgical difficulty were evaluated and compared between the two groups. RESULTS: There was no significant difference between the two groups in terms of demographic data. Hemoglobin changes (p  [Formula: see text]  0.0001) and the degree of surgery difficulty (p = 0.01) were significantly lower in Group L compared with Group P. In each group the drop in hemoglobin levels from baseline to 4 h postoperatively was significant (p  [Formula: see text]  0.0001). A significantly meaningful correlation was reported between hemoglobin changes and the degree of surgery difficulty with the size of the uterine and fibroids (p < 0.05). While a negative correlation was found regarding gravidity and surgery difficulty (r = −0.413, p = 0.02). Surgery duration was longer in Group P compared with Group L 70.66 ± 19.85 versus 66.16 ± 14.48, respectively, but with no significant difference (p = 0.32). No significant adverse reaction or serious complication was reported in the two groups. Hemodynamic parameters were kept in the normal range throughout the surgery. CONCLUSION: A combination of lidocaine plus epinephrine during abdominal myomectomy appears to be a safe and effective method in reducing blood loss.
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spelling pubmed-89055742022-03-10 Safety and efficacy of lidocaine plus epinephrine on intraoperative bleeding in abdominal myomectomy: A double‐blind clinical trial Mansour‐Ghanaei, Mandana Hosseinzadeh, Fatemeh Sharami, Seyedeh Hajar Biazar, Gelareh Noori, Fatemeh Asgari‐Ghalebin, Seyed Mohammad Health Sci Rep Original Research BACKGROUND: Uterine fibroid is a common benign pelvic tumor and abdominal myomectomy may cause excessive intraoperative bleeding, which may lead to adverse outcomes. OBJECTIVE: This study was planned to evaluate the effectiveness of the injection of lidocaine plus epinephrine to reduce intraoperative bleeding in abdominal myomectomy. METHODS: During October 2019 and May 2020, 60 eligible women with uterine fibroids were enrolled in a randomized controlled trial. Our patients were divided into two groups of lidocaine plus epinephrine defined as Group L and placebo defined as Group P. In group L, lidocaine 3 mg/kg plus 0.5 ml of adrenaline which reached to 50 cc with saline solution and in group P, 50 ml of normal saline was used. Both the combined solution and normal saline were infiltrated to the serous and myometrium above and around the fibroid before incision. Patients' demographic data, total operative time, hemoglobin changes, and the degree of surgical difficulty were evaluated and compared between the two groups. RESULTS: There was no significant difference between the two groups in terms of demographic data. Hemoglobin changes (p  [Formula: see text]  0.0001) and the degree of surgery difficulty (p = 0.01) were significantly lower in Group L compared with Group P. In each group the drop in hemoglobin levels from baseline to 4 h postoperatively was significant (p  [Formula: see text]  0.0001). A significantly meaningful correlation was reported between hemoglobin changes and the degree of surgery difficulty with the size of the uterine and fibroids (p < 0.05). While a negative correlation was found regarding gravidity and surgery difficulty (r = −0.413, p = 0.02). Surgery duration was longer in Group P compared with Group L 70.66 ± 19.85 versus 66.16 ± 14.48, respectively, but with no significant difference (p = 0.32). No significant adverse reaction or serious complication was reported in the two groups. Hemodynamic parameters were kept in the normal range throughout the surgery. CONCLUSION: A combination of lidocaine plus epinephrine during abdominal myomectomy appears to be a safe and effective method in reducing blood loss. John Wiley and Sons Inc. 2022-03-09 /pmc/articles/PMC8905574/ /pubmed/35284653 http://dx.doi.org/10.1002/hsr2.551 Text en © 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Mansour‐Ghanaei, Mandana
Hosseinzadeh, Fatemeh
Sharami, Seyedeh Hajar
Biazar, Gelareh
Noori, Fatemeh
Asgari‐Ghalebin, Seyed Mohammad
Safety and efficacy of lidocaine plus epinephrine on intraoperative bleeding in abdominal myomectomy: A double‐blind clinical trial
title Safety and efficacy of lidocaine plus epinephrine on intraoperative bleeding in abdominal myomectomy: A double‐blind clinical trial
title_full Safety and efficacy of lidocaine plus epinephrine on intraoperative bleeding in abdominal myomectomy: A double‐blind clinical trial
title_fullStr Safety and efficacy of lidocaine plus epinephrine on intraoperative bleeding in abdominal myomectomy: A double‐blind clinical trial
title_full_unstemmed Safety and efficacy of lidocaine plus epinephrine on intraoperative bleeding in abdominal myomectomy: A double‐blind clinical trial
title_short Safety and efficacy of lidocaine plus epinephrine on intraoperative bleeding in abdominal myomectomy: A double‐blind clinical trial
title_sort safety and efficacy of lidocaine plus epinephrine on intraoperative bleeding in abdominal myomectomy: a double‐blind clinical trial
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8905574/
https://www.ncbi.nlm.nih.gov/pubmed/35284653
http://dx.doi.org/10.1002/hsr2.551
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