Aim: This study aimed to assess the effectiveness of intramyometrial injection of epinephrine in reducing blood loss in abdominal myomectomy and to compare it with pericervical tourniquet.
Materials and Methods: Randomized controlled study carried on sixty patients suffering from symptomatic uterine fibroids and counseled for abdominal myomectomy. The patients were randomized into 3 groups of twenty each: control, tourniquet and epinephrine groups. A comparative analysis of the intra and postoperative outcomes of these groups was performed assessing the duration of operation, the blood loss and the blood transfusion rate.
Results: The epinephrine group had a statistically significant lower values of the fall in haemoglobin level and a significantly lower mean operative blood loss than the tourniquet and the control groups. Furthermore, the mean duration of operation was significantly shorter in the epinephrine group.
Conclusion: Intramyometrial injection of a solution of bupivacaine (50 ml of 0.25%) plus epinephrine (0.5 ml of 1 mg/ml) is very effective in reducing intraoperative bleeding during abdominal myomectomy. This solution is significantly more effective than using Foley's urethral catheter as a pericervical tourniquet. However it offers no additional
benefits over using a pericervical tourniquet regarding the need for blood transfusion.