Epidural anaesthesia and myomectomy-associated blood loss - a prospective randomised controlled study

Ginekol Pol. 2022;93(11):861-866. doi: 10.5603/GP.a2021.0186. Epub 2022 Jan 24.

Abstract

Objectives: The management of anaesthesia for patients with large myomas is particularly important due to disruption of hemodynamic as a result of massive haemorrhage, the prolonged duration of surgery and requirement for additional interventions. This study evaluated the effect of anaesthetic technique on blood loss in patients undergoing myomectomy due to large fibroid uterus.

Material and methods: A total of 156 patients that underwent myomectomy were randomized into two equal groups according to the type of anaesthesia: Epidural anaesthesia group and General anaesthesia group. The volume of blood loss and blood products transfusion was reviewed for each patient.

Results: The intraoperative blood loss and need for blood transfusion were significantly higher in general anaesthesia group (p < 0.001). The mean hematocrit change was 2.5 ± 1.5 vs 3.7 ± 2.9 % (p = 0.001) for both groups.

Conclusions: In the myomectomy planning of women with a large fibroid uterus, the team of gynecologists and anaesthesiologists should take care to choose the most optimal technique for anaesthesia.

Keywords: blood loss; epidural anaesthesia; general anaesthesia; myomectomy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anesthesia, Epidural*
  • Blood Loss, Surgical / prevention & control
  • Female
  • Humans
  • Leiomyoma* / surgery
  • Prospective Studies
  • Uterine Myomectomy*
  • Uterine Neoplasms* / surgery

Supplementary concepts

  • Uterine Anomalies