Optimal Dose of Pituitrin in Laparoscopic Uterine Myomectomy: A Double-Blinded, Randomized Controlled Trial

Abstract

Study objective: To determine the optimal effective dose of pituitrin in laparoscopic myomectomy for uterine leiomyoma.

Design: Double-blinded, randomized controlled trial.

Setting: Tertiary women's hospital in China.

Patients: Total of 118 patients who underwent laparoscopic myomectomy.

Interventions: Patients randomly received 0, 2, 4, or 6 units of pituitrin injected into the myometrium surrounding the myoma.

Measurements and main results: Rate of satisfactory surgical condition, hemodynamic changes, total surgical time, and blood loss were recorded. The rates of satisfactory surgical conditions were 6.7%, 72.4%, 89.7%, and 93.3% in groups 0U, 2U, 4U, and 6U, respectively; they were higher in groups 2U, 4U, and 6U than those in group 0U, but there were no significant differences among the groups 2U, 4U, and 6U. The blood loss was higher in group 0U than that in groups 2U, 4U, and 6U (p < .01). Pituitrin was associated with a transient decrease in blood pressures and an increase in heart rate in a dose-dependent fashion, with more pronounced changes in groups 4U and 6U, and these groups also required a higher amount of vasoactive drug to correct hemodynamic changes (p < .05).

Conclusion: Two units of pituitrin could provide a satisfactory surgical field with minimal hemodynamic changes for laparoscopic uterine myomectomy.

Keywords: Hemodynamics; Laparoscopic myomectomy; Leiomyoma; Pituitrin.